Taxes. Death. Rain on state holidays. Some things in life are inevitable—but becoming weaker and more frail as you age doesn’t have to be.

That's according to the Royal Osteoporosis Society (ROS), the U.K.’s largest national charity dedicated to improving bone health and beating osteoporosis.

This condition, associated with weakening bones and fractures, can affect everyone, but it is accelerated in women after the menopause due to falling levels of the hormone oestrogen.

The ROS states bone density peaks around the age of 30 to 35 for most people, before a steady, natural decline.

That means 50% of all women and 20% of all men over 50 will break a bone because of osteoporosis.

But that's not to say weaker bones are inevitable.

“Strong bones aren’t just something to think about later in life,” says Julia Thompson, a senior osteoporosis specialist nurse working with the ROS.

“They’re living, dynamic tissues that respond to how we move at every age, from childhood right through to our 70s, 80s and beyond.”

Thompson says that, while calcium and vitamin D are important for bone health, exercise is one of the most powerful tools we have for building and protecting bone strength at any age.

She and the ROS recommend everyone incorporate four forms of exercise into their weekly routine to “create a lifelong foundation for healthier bones”.

Four forms of exercise to protect your bones as you age

Thompson says the magic formula for strong and healthy bones is a combination of exercises that involve weight-bearing movements, strength training, balance and posture.

“You don’t necessarily need a gym membership or complicated exercise routines to see the benefits,” she tells Fit&Well.

Instead, a weekly mix of brisk walking, a couple of strength sessions and a few minutes of balance practice can “make a meaningful difference”.

“Your bones are with you for life—and the way you move today helps protect them for tomorrow,” she adds.

Include these four ROS-recommended exercises in your weekly routine to keep your bones healthy and ward off osteoporosis as you age.

1. Weight-bearing exercises

“Weight-bearing exercises tell your bones to stay strong,” says Thompson.

These typically involve moving your feet, like walking, hiking, climbing stairs or running, so your bones support your bodyweight.

Incorporating light-impact movement, such as skipping, hopping or even just brisk walking, can also stimulate bone cells to renew and strengthen.

“In your 20s to 40s, impact training in the form of plyometric exercise, with moves like broad jumps and box jumps, can help maximize peak bone strength,” she says.

“In midlife, light-impact work helps maintain density and in older age, gentle, low-impact weight-bearing exercise continues to stimulate bone health and maintain mobility.”

Exercises to try: Thompson suggests marching on the spot, brisk walking, jogging, running, stair climbing, aerobics using a low step, skipping, hopping and even dancing, if appropriate for your fitness level.

2. Strength training exercises

Next, Thompson highlights the importance of “building the muscle that builds the bone” with regular strength training.

This can involve working your muscles against any force or load, whether that’s your own bodyweight, resistance bands, dumbbells and kettlebells.

“When muscles pull on bones, they send powerful signals for bones to strengthen,” she explains, adding that “stronger muscles mean stronger bones—the two systems work together”.

Stronger muscles will also improve posture and joint support, reducing strain on your spine and hips, while helping prevent falls by improving stability.

“Strength training also becomes increasingly important as we age because muscle naturally declines with age too,” she says.

Exercises to try: Thompson suggests aiming for two to three sessions a week, working all major muscle groups with exercises like squats, lunges, step-ups, wall push-ups, rows and everyday activities such as carrying grocery bags or gardening.

If you own dumbbells (or plan to buy some), you can follow our beginner strength training routine.

3. Balance exercises

Good balance and coordination can help reduce the risk of falls, which can lead to painful fractures that further restrict activity, especially for those with osteoporosis.

That's why it’s essential you hone this skill throughout life, from the time you first learn to walk through midlife and old age.

Combined with weight-bearing and strength-building exercises, balance training can help keep you on your feet for longer, further protecting your bone health as you age.

Exercises to try: Thompson recommends standing on one leg for a few seconds at a time, practicing heel-to-toe walking along an imaginary straight line and marching firmly on the spot with high knees.

4. Posture exercises

Good posture and body alignment isn’t just about standing tall—it can help protect your spine by reducing strain on your joints, muscles and tendons, says Thompson.

“This is especially valuable for anyone who has suffered a spinal fracture or is concerned about height loss associated with osteoporosis,” she adds.

Postural exercises strengthen the muscles that support your spine, they improve flexibility, reduce pressure on your joints and can even ease symptoms like back pain, indigestion and breathlessness that Thompson says can be linked to spinal changes.

“They also make everyday activities, from lifting shopping bags to sitting at a desk, far easier on your back,” she says.

Thompson advises performing posture exercises two to three days per week, either by enrolling in a Pilates or yoga class to engage in exercises that naturally promote a healthy posture, or performing gentle moves in an armless chair.

Exercises to try: Practice sitting upright, tucking your chin toward your chest or tilting it to the side to stretch and strengthen deep neck muscles. Draw your shoulders back and squeeze them together to activate your upper-back muscles or perform a cat-cow stretch to mobilize your spine.

To learn more about how to look after your bones as you age, the Royal Osteoporosis Society has created this helpful guide on exercise for bone health.

You might assume that jumping exercises are something you should avoid as you get older, but you’d be mistaken.

Although low-impact workouts are great for helping you build strength, recover from injury and protect sensitive joints, incorporating some high-impact moves into your routines could also support your body, particularly for women.

“Jump training can improve bone health, balance, and your ability to perform all kinds of activities from walking up the stairs to catching yourself if you step off a curb,” says Dr Elizabeth Knight, who researches women's health at menopause wellness platform Respin.

“These are all key areas for long-term health, and midlife is the time when these indicators can start to decline, often slowly, so you might not notice until you’ve lost a lot,” she says.

According to Knight, a solid workout routine includes strength, cardio, mobility and impact exercises—such as jumping movements.

“Adding exercises like jump training to your routine before you experience falls, fractures and weakness is the goal,” she explains. “This is a proactive and evidence-based approach to longevity: keep it, so you don’t have to try to rebuild it later on.”

Want to get in on the jumping action? Respin Health have partnered with fitness company Peloton to create workouts and programmes designed specifically for midlife women navigating perimenopause and menopause.

Below, Peloton trainer Katie Wang has shared a 10-minute jumping workout you can try at home.

The 10-minute jumping workout for midlife women

The routine that Wang has shared doesn’t require any equipment and can be done from home.

Even though it might look like a lower-body workout, Wang says you should be engaging your upper body too. “Don’t forget to leverage your arms when you’re getting into jump training,” she advises.

“Focus on your body positioning to avoid injury. In general, think about starting and landing your jump in the same position, with full hip extension at the peak of your jump.”

The workout starts with a single round of warm-up exercises to perform back-to-back. Rest for 30 seconds then move onto the jump section of the workout.

Perform two rounds of the three jump exercises. Do each move for 60 seconds, taking a 15-second rest before moving onto the next exercise.

If this is too challenging, shorten the exercise time and extend the rest time. For instance, work for 45 seconds and rest for 30 seconds.

The warm-up and workout time is just under 10 minutes in total.

Warm-up

1. Alternating knee lift

Time: 30sec Rest: 0sec

• Stand with your feet hip-distance apart and arms by your sides (or with your hands on your hips to aid balance), and engage your core.
• Lift one knee to hip height, keeping your core engaged and your chest facing forward.
• Repeat on the other side.
• Continue at a steady pace, alternating sides with each rep.

2. Unweighted squat

Time: 30sec Rest: 0sec

• Stand with your feet just wider than hip-distance apart with your toes pointed slightly out.
• Push your hips back and bend your knees to lower, keeping your chest up, until your hips are at knee height, or as close as your mobility allows.
• Push through your heels to stand back up.

3. Unweighted squat to calf raise

Time: 30sec Rest: 30sec

• Stand with your feet just wider than hip-distance apart with your toes pointed slightly out.
• Push your hips back and bend your knees to lower, keeping your chest up, until your hips are at knee height, or as close as your mobility allows.
• Push through your heels to stand back up and lift your heels.
• Pause on your tiptoes momentarily, then lower your heels to the floor with control.

Workout

Complete two rounds of the following exercises.

1. Front-to-back hop

Time: 60sec Rest: 15sec

• Stand with your feet hip-distance apart and your toes pointing forward.
• Bend your knees slightly and swing your arms behind you.
• Jump forward by about one or two feet, swinging your arms overhead to aid momentum.
• Jump backward to your original position, again swinging your arms.
• Stay light on your feet and keep the jumps small and quick.

2. Side-to-side hop

Time: 60sec Rest: 15 sec

• Stand with your feet hip-distance apart and your toes pointing forward.
• Bend your knees slightly and swing your arms behind you.
• Jump to the side by about one or two feet, swinging your arms overhead to aid momentum.
• Jump back to your original position, again swinging your arms.
• Stay light on your feet and keep the jumps small and quick.

3. Broad jump

Time: 60sec Rest: 15 sec

• Stand with your feet slightly wider than hip-width apart.
• Push your hips back and bend your knees to lower until your hips are at knee height and swing your arms behind you.
• Jump forward as far as you can, swinging your arms forward to help generate momentum.
• Land softly with your knees bent, absorbing the impact.
• Stand, turn around and reset your stance, before repeating the movements to jump back to the start position.
• This move is more about controlled explosive power than speed, so take your time to jump as far as you can.

How to add jump training into your exercise routine

It’s important to start small with jump training and give your body time to recover after a jump workout. But, equally, it’s important to start. A 10-minute workout like this, which spends time warming up your joints, is an ideal starting point.

Perhaps you've been wary of high-impact exercises previously, but Knight says there's no need to be. “I think a lot of people in midlife (or older) worry it might cause injury, but jump training is safer than many people think,” she says.

“Most people can safely start adding jumping in place to their routine, even people with low bone density.”

However, Knight warns that there are a few injuries and issues that don’t respond well to jump training. “If you’ve had a vertebral compression fracture, have a current foot or lower leg injury, have severe balance difficulties, or have pelvic organ prolapse, you should chat with your healthcare team to find a plan that’s safe for you,” she advises.

“Often, with the right plan, you’ll still be able to progress to impact training, it just might take a little extra time and care.”

Building strong, toned arms isn’t just about aesthetics—it’s one of the best things you can do for your long-term health and everyday functional strength.

If you’re not sure how to get started, this five-move workout with just a pair of dumbbells is one that midlife strength training coach Edwina Jenner recommends.

“This is my go-to session for strong and more defined arms because it focuses on fast and efficient moves in just three strong sets,” she tells Fit & Well.

While anyone can do this workout and see results, this style of upper-body work becomes increasingly important in midlife.

“From a physiological standpoint, women naturally lose muscle mass from their mid-30s and this accelerates as estrogen declines in perimenopause,” Jenner explains.

“If you’re not actively preserving and building your muscles, you will lose them and that impacts everything from metabolism to joint stability.”

Jenner’s routine focuses on movements that help build and maintain lean muscle, and improve muscle tone. At the same time, strength training workouts will support weight management and joint health.

As you get more comfortable with the moves, gradually increase the weight of the dumbbells you use from one workout to the next—this keeps the exercises challenging so you continue seeing results.

“Women will start to feel stronger within six weeks and they will start to notice better control, less fatigue and more confidence using weights,” says Jenner.

“At 12 weeks, they will begin to see significant development and strength gains provided they are consistent and progressively lift heavier weights to support progress,” Jenner adds.

By the third set of each exercise, the weight should feel challenging but still allow you to maintain good form and posture.

Jenner adds that this shouldn’t be the only upper-body workout in your weekly strength training plan.

“This routine focuses on triceps and biceps, but it doesn’t include larger compound movements for your chest, back or shoulders, which are important for overall strength,” she says.

Jenner recommends doing this sequence once per week, alongside one or two full-body or other upper-body workouts that include exercises such as rows, presses, and push movements to form a well-rounded training plan.

You can find three full-body dumbbell workouts in our strength training routine for beginners.

How to do the dumbbell arms workout

The five exercises in this arms workout are:

1. Crossbody curl
2. Triceps kickback
3. Hammer curl
4. Triceps extension
5. Single-arm biceps curl

1. Crossbody curl

Sets: 3 Reps: 10-12

• Stand with your feet hip-width apart, holding dumbbells by your thighs with your palms facing.
• Bend your right elbow to lift the dumbbell to your left shoulder.
• Lower slowly, then repeat on the other side.
• Continue, alternating sides with each rep.

Trainer tip: Keep your elbow close to your body throughout the movement.

2. Triceps kickback

Sets: 3 Reps: 10-12

• Stand with your feet hip-width apart, holding dumbbells by your sides.
• Hinge forward from your hips, pushing your butt back and bending your knees slightly.
• Press your upper arms into your torso, and bend your elbows to 90°. This is your starting position.
• Extend your right elbow to lift the dumbbell behind you.
• Squeeze your triceps, then lower the dumbbell back to the starting position.
• Repeat on the other side, alternating sides with each rep.

Trainer tip: Remember to keep your elbows high and reset them after each movement.

3. Hammer curl

Sets: 3 Reps: 10-12

• Stand with your feet hip-width apart, holding dumbbells by your sides, palms facing.
• Bend your elbows to lift the weights to your shoulders.
• Lower slowly.

Trainer tip: Keep your elbows stable and close to your torso throughout.

4. Triceps extension

Sets: 3 Reps: 10-12

• Stand with your feet hip-width apart, holding the end of one dumbbell in both hands overhead.
• Bend your elbows to lower it carefully behind your head.
• Extend your elbows to lift the dumbbell back to the starting position, squeezing your triceps at the top.

Trainer tip: Keep your elbows pointing forward as you bend them.

5. Single-arm biceps curl

Sets: 3 Reps: 10-12

• Stand with your feet hip-width apart, holding dumbbells by your thighs, with your palms facing.
• Bend your right elbow to lift the dumbbell to your right shoulder.
• Lower slowly, then repeat on the other side.
• Continue, alternating sides with each rep.

Trainer tip: Keep your elbows close to your body and avoid swinging.

Looking after your upper body is important throughout life, but especially as you get older to maintain your independence.

That’s why midlife strength coach Kate Rowe-Ham created a five-move dumbbell upper-body routine to build strong arms.

Rowe-Ham’s routine is less about aesthetics and more about building strength and confidence.

The trainer and author of The Longevity Solution, says this five-move workout is particularly important for women during menopause.

“Declining estrogen accelerates muscle loss during menopause—but resistance training helps maintain and rebuild lean muscle, which is critical for strength, metabolism and long-term health,” says Rowe-Ham.

Loading the arms and spine helps protect your bones against osteoporosis, while strength training generally offers mood-boosting benefits too.

“It’s also associated with improved mood, reduced anxiety and better sleep quality, all of which can be disrupted during menopause,” says Rowe-Ham.

She recommends doing this workout twice a week with at least one rest day in between.

How to do the dumbbell upper-body workout

Watch the videos in Rowe-Ham’s Instagram post for how to do each exercise.

What weights to use in this workout

If you’re new to strength training, start with 4-10lb (2-4kg) dumbbells.

“The weight should feel challenging by the final two repetitions while still allowing proper form,” says Rowe-Ham.

As you progress over four to six weeks, try increasing your weights to 12-20lb (5-8kg).

In the long term, aim for 20-26lb (8-12kg) for row movements, and 12-22lb (6-10kg) for overhead movements.

“Gradual progression is what protects muscle, bone and long-term metabolic health,” explains Rowe-Ham.

“If you can comfortably perform more than 12 repetitions, the weight is likely too light—but if your form breaks before eight repetitions, it is too heavy.”

If dumbbells feel too heavy or you don’t have any at home, you can also try this workout without weights.

I’m always telling my personal training clients to eat more protein. It helps rebuild and strengthen muscles after exercise, and it’s also naturally filling—providing slow-release energy, which is helpful for curbing snacking and preventing blood sugar crashes.

If you’re in the perimenopausal camp like me, protein can be a useful tool to help with many of the hormonal shifts and symptoms that come with this period of life.

According to Paige Lindgren, a Los Angeles-based certified hormone specialist and holistic nutritionist whose upcoming cookbook Sync & Savor is out this April, getting enough protein is one of the most “impactful and underrated things women can do to feel better day to day.”

“Protein gets talked about a lot in the context of muscle or weight loss, but for women, it plays a much bigger role than that,” Lindgren tells Fit&Well.

“It’s the most satiating macronutrient. It slows digestion, keeps food in the stomach longer and sends stronger fullness signals to the brain than carbs or fats alone.”

Lindgren explains that when protein intake is low, the body can struggle to produce and regulate hormones involved in metabolism, stress response and blood sugar balance.

“Hormones are essentially chemical messengers, and many of them rely on amino acids—the building blocks of protein—to be made and function properly,” she says.

“Protein also helps keep blood sugar stable. When blood sugar spikes and crashes, it puts extra stress on hormones like insulin and cortisol (the stress hormone).

“When you add protein to meals, it slows digestion, reduces those mood swings and creates a much more hormonally supportive environment.”

How perimenopausal women could benefit from increased protein intake

“Many perimenopausal women benefit from eating more protein because when estrogen fluctuates it commonly leads to changes in muscle mass, insulin sensitivity, appetite and energy,” says Lindgren.

“Protein helps preserve lean muscle—which naturally declines with age—and supports metabolic health as the body transitions.

“By stabilizing blood sugar, it helps reduce crashes and irritability. By supporting muscle, it keeps metabolism more resilient,” she says.

“Plus, eating enough protein can also help with the fatigue that often shows up during this phase. While protein needs are individual, many women feel noticeably better when they eat it with every meal instead of it just being an afterthought.”

Protein can help keep energy levels stable

For those of us feeling exhausted, lack of protein can make matters worse.

“When energy is consistently low, the body looks for quick fixes. This often shows up as cravings for sugar, caffeine or ultra-processed foods,” Lindgren explains.

“Low energy can also make it harder to cook nourishing meals, move your body or keep up with healthy routines, creating a cycle that’s tough to break.”

And repeated energy dips have consequences, contributing to “blood sugar dysregulation, weight gain and burnout.”

Lindgren says: “Eating enough protein helps prevent this by keeping energy more stable and reducing reliance on short-term stimulants or comfort foods.”

How much protein is right?

Lindgren explains that protein needs differ. “Factors like body size, activity level, age and hormonal status matter more than gender alone,” she says.

“Many women tend to underestimate how much they need. When it comes to perimenopause, protein isn’t just about macros or aesthetics. It’s a powerful tool for feeling more balanced, resilient, and energized in everyday life.”

But, she adds: “Protein doesn’t need to be complicated or tracked obsessively. Simply prioritizing a quality protein source at each meal can make a noticeable difference in hormones, appetite and energy within weeks.”

I’m a firm believer that any movement is better than none. On days when I’m feeling tired and lack motivation, I tell myself that I’ll just do five minutes and inevitably end up working out for longer.

I’ve found that just 15 minutes of strength training can help boost my energy, and contribute toward improving my fitness levels and building muscle mass when done consistently.

This kind of efficient and effective exercise is particularly helpful when it comes to easing menopause symptoms, from low mood to fatigue and brain fog.

Quick workouts like the one I’ve created below—that I do myself and recommend to my personal training clients—can leave you feeling more energized, clear-headed and hopefully, happier.

How to do the workout

1. Kettlebell Romanian deadlift
2. Goblet squat
3. Alternating kettlebell gorilla row
4. Plank shoulder tap
5. Kettlebell halo
6. Bird dog

Aim to perform each move for 40 seconds with 20 seconds of rest in between, and complete two rounds.

If you have more time, you can do four rounds for a 30-minute workout.

1. Kettlebell Romanian deadlift

Time: 40sec Rest: 20sec

• Stand with your feet hip-width apart and a slight bend in your knees, holding a kettlebell with both hands in front of your thighs.
• Roll your shoulders back and brace your core.
• Hinge forward from your hips, pushing your butt back to lower the weight slowly, keeping it close to your shins.
• Pause, then squeeze your glutes as you extend your hips to return to standing.

2. Squat

Time: 40sec Rest: 20sec

• Stand with your with feet shoulder-width apart and toes pointing slightly out.
• Place your hands on your hips or in front of your chest, palms together.
• Push your hips back and bend your knees to lower.
• Pause when your hips reach knee height.
• Drive through your feet to stand back up, squeezing the muscles in your buttocks at the top.

3. Alternating kettlebell gorilla row

Time: 40sec Rest: 20sec

• Stand with your feet hip-width apart, with a kettlebell on the floor in front of you.
• Hinge forward from your hips, pushing your butt back and bending your knees slightly. Your back should remain flat throughout.
• Take hold of the kettlebell in one hand.
• Keeping your torso stable, lift the kettlebell to your ribcage, drawing your bent elbow past your torso.
• Lower the kettlebell to the floor with control.
• Repeat on the other side, alternating arms with each rep.

4. Plank shoulder tap from knees

Time: 40sec Rest: 20sec

• Start on your hands and knees with your shoulders directly above your hands and your hips directly above your knees.
• Engage your core.
• Keeping your hips stable, raise one hand off the floor and tap your opposite shoulder.
• Return to the starting position and repeat on the other side.

To make this more challenging, walk your hands forward until your torso is at a 45° angle.

5. Kettlebell halo

Time: 40sec Rest: 20sec

• Stand holding a kettlebell upside down by the handle with both hands.
• Raise it to one shoulder for your starting position.
• Move it behind your head, over your other shoulder, then back round to the starting position.
• Change direction and complete another rotation.
• Continue, alternating direction with each rep.

6. Bird dog

Time: 40sec Rest: 20sec

• Start on your hands and knees with your shoulders over your wrists and hips over your knees.
• Brace your core, then extend one arm in front and extend your opposite leg behind you.
• Keeping your hips and shoulders stable throughout.
• Pause, then return to your starting position and repeat on the other side.

The menopause is a difficult period to navigate, with an often confusing and unique series of changes to contend with.

One common menopause symptom is abdominal weight gain, despite women not changing their diet or lifestyle. Hormonal changes, blood sugar swings, bad quality sleep and rising stress often drive this.

So what can be done? I spoke to leading menopause expert, fitness trainer and author of The Longevity Solution (out Feb 12, Yellow Kite), Kate Rowe-Ham about what midlife women could do today to support their long-term health.

“I have a three-step rule when it comes to nutrition: have 30 grams of protein with every meal, 30 grams of fiber a day, and two liters of water,” she tells Fit&Well.

“I also recommend taking a walk for 10 minutes after every meal if you can. This helps with digestion and also balances blood sugar levels.”

Protein and fiber are naturally filling, and both are important for preventing age-related muscle loss (sarcopenia), supporting bone strength and health, and maintaining a stable weight—because they keep you fuller for longer.

Staying hydrated during menopause regulates body temperature and can help reduce symptoms such as hot flushes, night sweats and dry skin. When you drink enough water, it also helps reduce joint stiffness—a common issue during this life stage.

Rowe-Ham says we often overcomplicate nutrition. “I would say, think about what you can add to your diet rather than what you can take away.”

In her new book, she shares recipes that add fiber; for example, in her veggie bolognese, she uses lentils.

The menopause expert also says meal planning and batch cooking is a useful way to make eating healthier easier to achieve. “I don’t always manage to do it, but on the weeks I’m organized it really helps me and the family to eat well,” she says.

Estrogen is an important hormone for maintaining muscle quality, with a big impact on tendon and joint elasticity, but it declines during perimenopause and menopause—weakening the core and pelvis.

This hormonal shift can also mean that women gain weight despite not changing their diet or lifestyle. This is due to a decrease in metabolism, an increase in appetite and a change in fat distribution leading to more belly fat.

Broken sleep and anxiety—other common symptoms of perimenopause and menopause—can also impact body composition during this transitional stage. This is because if you are anxious or not sleeping well, the body thinks it is in fight-or-flight mode and produces more of the stress hormone cortisol. This signals to the brain that it needs to hold onto fat reserves in case of emergency, which can lead to weight gain.

Women can compensate for the weakening in the core and pelvis by doing exercises that target the abdominal muscles. Here are six moves that I’ll be using in my new MenoCore strength training course, to get you started.

The six-move core and pelvic strength workout

You will need a mat, small Pilates ball and some light dumbbells for this workout. Here are the moves:

1. Bird dog
2. Side plank
3. Plank hip dip
4. Weighted dead bug
5. Glute bridge heel roll
6. Glute bridge and Pilates ball press

1. Bird dog

Sets: 2 Reps: 12 each side

• Start on your hands and knees.
• Extend and lift your right arm and left leg so they form a straight line with your torso.
• Return to the start with control, then repeat using your left arm and right leg.
• Continue, alternating limbs with each rep.

2. Side plank

Sets: 2 Time: Hold for as long as you can, then swap sides

• Lie on your right side, with your left leg stacked on top of your right.
• Prop yourself up on your right elbow, with your shoulder directly above it.
• Lift your hips so your body is in a straight line.
• Extend your left arm straight up and rotate your head to look up at your hand.
• Hold for as long as you can maintain good form for, then swap sides.

3. Plank hip dip

Sets: 2 Reps: 12 each side

• Start on your forearms and toes, making a straight line with your body—this is your plank position.
• Rotate your hips to the left to dip them towards the floor—keeping your core engaged throughout.
• Return to the center, then dip your hips to the right.
• Continue, alternating sides with each rep.

4. Weighted dead bug

Sets: 2 Reps: 12 each side

• Lie on your back with your legs in tabletop position, holding light dumbbells above your chest.
• Ensure your back is flat on the mat and it doesn’t arch at any point during the move.
• Lower your right arm behind you and extend and lower your left leg.
• Return to the start, then repeat on the other side.
• Continue, alternating sides with each rep.

5. Glute bridge heel roll

Sets: 2 Reps: 12 each side

• Lie on your back with your knees bent and the Pilates ball under your right foot.
• Make sure your back is flat on the mat, then squeeze your glutes as you raise your hips up into a glute bridge.
• Maintaining the glute bridge, extend your right leg, rolling the ball forward—once your leg is fully extended the ball should be in contact with your calf.
• Roll the ball back to the starting position.
• Complete all your reps, then switch sides.

6. Glute bridge and ball lift

Sets: 2 Reps: 12

• Lie on the mat with your back flat, knees bent and feet flat on the floor.
• Hold a small Pilates ball in your hands above your chest.
• Push your hips up as you raise into a glute bridge, at the same time extending your arms to lift and squeeze the ball.
• Lower the ball and your hips with control to the start.

I currently have three perimenopausal clients as a personal trainer and all are managing a frozen shoulder, among other symptoms.

According to menopause expert Dr Louise Newson this is fairly common, and thought to be caused by inflamed tissue around the shoulder joint. “This tissue then gets tighter and shrinks,” says Newson, founder of the Balance menopause app and host of The Doctor Louise Newson Podcast.

“It tends to first affect external rotation of your shoulder—when you turn your arm away from your body—and abduction of your shoulder, when you move it out to the side.

“If you have frozen shoulder, you’ll often experience pain—usually worse at night—and stiffness, which can restrict movement.

“Many women find it difficult to reach for things, particularly overhead or to the side, like hanging clothes or fastening their seatbelt. Some people may find it difficult to get dressed or brush their hair.

“The hormones estradiol, progesterone and testosterone work to reduce inflammation, support joint health and lubrication, and promote connective tissue integrity (keeping the body’s various connective tissues healthy and working well). During perimenopause and menopause, levels of these hormones fluctuate and reduce.”

Depending on which stage you’re in, Newson says exercise can help.

“During the early inflammation stages, it’s important not to push on through regardless, as the shoulder can get more inflamed—physiotherapy will focus on restoring shoulder mobility.

“During the developed stage, physiotherapy may be more intensive. You can also try putting a heat pack or hot water bottle on your shoulder for up to 20 minutes at a time.

“Many women find that taking the right dose and type of Hormone Replacement Therapy (HRT) and testosterone improves symptoms associated with frozen shoulder, as well as improving other symptoms, including muscle and joint pains.”

How exercise can help frozen shoulder

I also enlisted the help of physical therapist Regie Tiu, owner of Restore Plus PT, who has compiled some exercises to help manage a frozen shoulder.

Tiu has created exercises for the early inflammation stages of frozen shoulder, with demonstrations on how to perform them safely and effectively.

“Frozen shoulder, also called adhesive capsulitis, happens when the shoulder joint capsule becomes thick, tight and inflamed,” says Tiu. “This causes pain, stiffness and a gradual loss of movement. It feels like your shoulder is frozen in place, which explains the name. It often develops slowly and goes through stages: freezing, frozen, thawing and resolution.

“During peri-and menopause, estrogen levels drop, which can affect collagen levels and joint tissue elasticity. This hormonal shift makes joints—especially the shoulder—more prone to inflammation and stiffness. Stress, poor sleep, poor posture and less physical activity increase the risk of frozen shoulder.

“But gentle and consistent movement is the key. Exercise increases blood flow, helps lubricate the shoulder joint and slowly stretches the tight capsule. Over time, this reduces pain, restores movement and prevents the shoulder from getting stiffer. Even little daily stretches make a big difference when done correctly and consistently.”

How to do the exercises for frozen shoulder

Tiu recommends doing the exercises two to three times a day for the best results.

1. Pendulum exercise

Reps: 15-20 each direction

2. Wand exercise

Reps: 10 each direction

3. Wall slide

Reps: 3 each direction

4. External rotation stretch

Reps: 3

5. Posterior capsule stretch

Reps: 3

6. Towel stretch

Reps: 3

What should people do to avoid aggravating frozen shoulder?

“Avoid pushing through sharp pain or forcing your arm into positions that it is not yet capable of,” says Tiu. “Recovery from frozen shoulder takes time so stick with gentle stretches.

“Do keep in mind that the stretches can be a little painful, but it should not be excruciating pain. Applying heat before exercising can help loosen the shoulder up, and ice after to calm the inflammation down. Also, avoid long periods of immobility like sleeping on the same side or keeping the arm in a sling, unless prescribed.

“Move as much as you can as often as you can. Most people start to notice small improvements within a couple of weeks of consistent exercise. Full recovery can take several months depending on the stage of frozen shoulder. The key is consistency: exercising a few minutes three times a day every day is far better than pushing too hard once in a while.

“Even though it can take a while to recover from frozen shoulder, it’s not permanent and does not require surgery. The most important thing is to be patient, stay consistent, keep moving and get professional help if the pain doesn’t improve or if the stiffness worsens. Working with a physical therapist can help tailor exercises to your stage and accelerate your recovery.”

Not to be a downer, but menopause symptoms are a real grab bag of awful, ranging from brain fog, hot flushes and joint pain to anxiety, low mood, weight gain and poor sleep.

With so many physical and mental symptoms to navigate, it’s little wonder many of us struggle during this period.

So when health and fitness platform Pvolve launched a Menopause Strong plan, a six-week program designed to help women manage symptoms with strength training, cardio workouts and recovery, I wanted to find out more.

Pvolve put me in touch with board-certified OB/GYN Dr Jessica Shepherd, advisory board member of women’s health and longevity at Pvolve, and what she said surprised me.

“The biggest misconception about menopause is that it’s a pause or a decline—a time when your body and life slow down,” Shepherd told me. “In reality, menopause is a biological evolution. It’s a chance to reconnect with your body, reclaim strength and prioritize health in ways that can profoundly impact how you feel physically and emotionally.

“Too often, women are told to just ‘accept’ symptoms, but with the right strategies, menopause can be a stage of empowerment and healthy aging.”

Shepherd, of course, is not minimizing menopause symptoms. “In addition to side effects like hot flashes, this life stage can have an impact on several areas of your body and the functioning of it,” says Shepherd.

“Every person’s experience with this phase is different, but what menopause does to your body can be impacted positively with nutrition and movement. By proactively embracing this phase, we can then prioritize our happiness and a path of optimal health.”

I liked the sound of that! So I asked Shepherd to share the overarching changes she recommends women make to help ease menopause symptoms and feel more like themselves again.

1. Prioritize exercise but set achievable goals

“Exercise is non-negotiable during menopause,” says Shepherd, but you don’t need to make impossible goals that you’ll only feel bad about if you can’t stick to them.

“Even 30 minutes of the right exercise a few times a week can make a remarkable difference in energy, mood and confidence,” she says.

“Strength training preserves and rebuilds muscle mass and supports bone density. While cardiovascular work—especially short, intense intervals—supports heart and brain health, and stimulates bone.

“Recovery, mobility, and pelvic-floor work regulate hormones, reduce inflammation and improve sleep and energy.

“Put really simply, movement is a key lever for controlling how you feel during this stage.”

2. Eat more protein and fiber

“Prioritize protein to support muscle mass and fiber to support metabolic and cardiovascular health,” says Shepherd. Protein is essential for maintaining and building muscle, and the more muscle you have, the more calories you burn at rest.

Fiber is known for lowering cholesterol and blood pressure. This keeps the heart healthy, boosts cardiovascular health and can reduce your risk of cardio-metabolic disease.

3. Focus on self-care

“Incorporate practices like meditation, gentle stretching or foam-rolling to manage stress and support sleep,” says Shepherd.

“Good sleep hygiene and lower stress levels both help to regulate hormones and overall wellbeing. Also, consider HRT as there are wide fluctuations and progressive decline in estrogen levels.”

4. Understand it

“Explore digital platforms like the Hers app [where Shepherd is chief medical officer] to get accessible, empowering support that meets women on their own terms. It’s full of content crafted by clinical experts in psychology, nutrition, exercise, sleep and more to set you up for success,” says Shepherd.

From the age of 30, we naturally lose lean muscle mass as well as bone density, and this process speeds up for women in menopause. Other physiological changes can mean exercise routines that were once a source of strength no longer work, too. But all is not lost—far from it.

“The key to aging well is to build muscle,” says Antonietta Vicario, chief training officer at fitness app Pvolve, which recently launched a six-week fitness program called Menopause Strong. It’s designed for women in perimenopause, menopause and post-menopause to improve strength, mobility, energy levels and mood.

“Menopause is a natural biological evolution, not a pause,” Vicario, tells Fit&Well. “The Menopause Strong plan provides a structured, evidence-based roadmap to help women reclaim strength, confidence and vitality during this stage of life.”

Vicario says there are four main areas it’s worth menopausal women working on.

1. Muscle mass: Preserving muscle supports metabolism, energy, insulin sensitivity, daily function and overall strength.
2. Bone health: Declining estrogen increases the risk of bone density loss. Weight-bearing and plyometric (jumping) exercises are essential for prevention.
3. Joint health and mobility: Maintaining mobility and stability reduces pain, improves posture and decreases fall risk.
4. Pelvic floor strength: Supports bladder control, core stability and overall movement efficiency.

The programme addresses all four, and adds recovery work too.

Vicario recommends strength training three to four times a week to preserve muscle, and boost your bone health and metabolism. Then prioritize mobility work two to three times to keep joints healthy and flexible. Recovery sessions are also important to reduce stress, regulate hormones and boost energy, she says.

“The key is to focus on strength and high-intensity intervals while starting small and building gradually. Enjoyable exercises help create sustainable habits, and even 20-30 minutes a few times a week can make a meaningful difference.”

Vicario, who has created a taster workout of what to expect from Menopause Strong. Scroll down to give her mini workout a try.

Five moves will boost muscle, bone strength, mood and mobility in midlife women

1. Internal rotation deadlift

Sets: 1 Reps: 15-30 each side

How to do it:

• Stand in a split stance, with your right foot in front of your left, with a slight bend in your knees and holding heavy (10-15lb) dumbbells.
• Keeping your hips pointing forward, turn your right foot in.
• Shift your weight into your right leg and hinge forward from your hips, lifting your left leg behind you and letting your arms hang down, keeping your hips and shoulders square to the floor as you hinge.
• Pause, then push your hips forward to stand up, lowering your left foot to tap the floor behind you.

Vicario says: “This exercise builds stability to help us have better control of our bodies and prevent debilitating falls. It also increases the mobility in our hips, which is so important for hip, low back and pelvic floor health, especially because the loss of estrogen during menopause can make our joints feel stiffer.

“Aim for 15-30 repetitions and then hold the balance at the top for 15-30 seconds, building up in repetitions over time. Then swap sides.”

2. Sumo squat to overhead press

Sets: 3 Reps: 20-30 Rest: 2min

How to do it:

• Stand with your feet wider than hip-width apart, holding heavy (10-15lb) dumbbells in front of you. Engage your core and squeeze your shoulder blades together.
• Bend your knees and push your hips back to lower until your hips are as low as your knees (or as far as your mobility allows) and touch the floor with the dumbbells.
• Exhale as you push through your heels to stand up, bending your elbows to raise the dumbbells to your shoulders, then pressing them overhead in one smooth motion, making sure not to arch your lower back.
• Lower the dumbbells to your shoulders, extend your elbows to lower the dumbbells to your thighs and go straight into the next rep.

Vicario says: “This move helps us build metabolically active muscle in our glutes and shoulders, and can also elevate the heart rate if done powerfully, boosting our cardiovascular system.

“It also trains us on how to safely lift heavy objects from the floor, strengthening the glutes and intentionally using our exhale breath to brace through the core so we don’t strain the lower back.

“As you gain strength, you can increase the weight load to build power, which naturally declines with age unless we train it.”

3. 180° jump

Sets: 3 Time: 30sec Rest: 30sec

How to do it:

• Stand with your feet shoulder-width apart.
• Bend both knees, then jump straight up and rotate 180° in the air.
• Land facing the opposite direction. Be sure to land softly through your joints, making contact with the floor through your toes first, then the balls of your feet, then your heels.
• Continue for time.

Vicario says: “In menopause, it’s crucial to maintain heart health, bone density and cognitive function through multi-directional plyometrics (jumping exercises). These stimulate bone density, because our bones respond and strengthen when given stimulus through impact.

“When we incorporate short, high-intensity intervals of cardiovascular exercise, this quickly shunts blood into our brain, which can help with memory, focus and cognitive health.”

4. Alternating lateral power-up

Sets: 3 Time: 30sec Rest: 2min

How to do it:

• From standing, jump straight up.
• Land softly on your right foot and take a big step to the left with your left foot.
• Bring your right foot to meet your left, then jump straight up.
• Land softly on your left foot and take a big step to the right with your right foot.
• Bring your right foot to meet your left, and repeat the above. Moving smoothly from side to side.

5. Diaphragmatic breathing

Sets: 1 Time: 1min

How to do it:

• Either seated upright in a chair, on your knees or even lying down, close your eyes, take your hands to your ribcage and take deep inhales and exhales.
• Feel your ribs expand front to back and side to side as you inhale and hug in as you exhale.
• Slow your breath to a comfortable rhythm, taking full inhales and exhales to calm your nervous system.

Vicario says: “By incorporating mindfulness practices such as breathwork, meditation and recovery, you can stimulate your parasympathetic nervous system—aka the rest and digest response. This will help to calm the nervous system, ground your energy, improve mood, reduce inflammation and regulate your hormones.”

You’ll need Pvolve’s Longevity bundle and dumbbells ranging from 5-15lb pounds to follow the Menopause Strong plan. Now’s a great time to give it a try, with 20% off sitewide with code BF20 for Black Friday.

Pvolve also has studios throughout the U.S. and Canada, so check out Pvolve’s locations to see if there is a studio near you.

A healthy gut is crucial for the body to run well, affecting everything from immunity, sleep and mood.

“A rich, balanced community of gut microbiome is generally linked to resilience,” explains Dr Jenna Macciochi, director of science and innovation at Ancient + Brave, which sells gut health supplements, like True Biome.

“It’s kind of like having lots of good players on a sports team—so no single species dominates or allows pathogens (disease-triggering micro-organisms) to take over in the body and make you sick.”

Unfortunately, the menopause can impact the gut in a number of unwanted ways.

“During the menopausal transition, levels of the hormone estrogen decline and this can reduce the variety and types of bacteria that live in the gut,” says Macciochi.

The change in estrogen can also negatively affect something called barrier integrity, which Macciochi explains “is how well the gut lining keeps the contents of the intestine, such as bacteria and toxins, separate from the bloodstream. Good integrity means a strong ‘wall’ with no gaps and this protects the body against infections and illnesses.”

During menopause, women also produce fewer short-chain fatty acids (SCFAs). “These are chemical messengers that feed gut cells, keep the gut lining strong, and impact the immune system and metabolism,” says Macciochi.

“A drop in SCFAs can lead to inflammation and negative impacts on digestion, bowel regularity and nutrient absorption. It can also increase the risk of weight gain. Ultimately, this can have knock-on effects to common experiences of menopause, including mood, stress levels and sleep quality.”

But what you eat can contribute to better gut health, so if you’re going through, or approaching, the menopause, it pays to give your microbiome a fighting chance by including these four types of food in your diet.

What to eat to improve gut health during menopause

High-fiber vegetables and wholegrains

“Fiber such as broccoli, lentils and oats acts as a prebiotic, meaning it feeds beneficial gut microbes,” says Macciochi. “When these microbes ferment fiber during the digestive process, they produce SCFAs that strengthen the gut lining, support immunity and help regulate blood sugar.”

Polyphenol-rich foods

Blueberries, dark-skinned grapes, green tea, coffee, pomegranate and extra virgin olive oil are all rich in polyphenols. These are plant compounds that are full of antioxidants, nourish good gut health by feeding certain microbes and they have anti-inflammatory properties that protect the body against chronic diseases, says Macciochi.

Fermented foods

Eating fermented foods makes it easier for nutrients to be absorbed by breaking down natural sugars and starches in food before the digestive process begins. “Greek yogurt, kefir, kimchi and sauerkraut introduce helpful live cultures that can temporarily add to gut diversity and support digestion,” says Macciochi.

Nuts, seeds and legumes

“These provide a mix of fiber, plant protein and minerals that keep bowel movements regular, and help to stabilize blood glucose and energy levels,” says Macciochi.

Thankfully, the notion that you are over the hill once you hit 40 has gone out of fashion.

This decade can bring plenty of positives, but one downside is a gradual loss of muscle mass, which affects everything from your metabolism to your mobility and strength.

The best way to offset this is by resistance training—lifting weights or using your bodyweight to rebuild strength and muscle, support your joints and stop your metabolism from slowing down.

You don’t need complicated moves, a new gym membership or fancy equipment to do this—a simple set of home dumbbells is enough to make a difference.

Carly Harvey is a trainer who specializes in helping women over 40 build strength and confidence, and recommends this four-move routine for beginners.

“It’s perfect for women 40 and above who want to build lean muscle to support weight management and improve joint aches that are heightened in the peri and menopause phase of life,” she says.

How to do the dumbbell workout

The workout in brief

1. Goblet squat: 3 x 10
2. Shoulder press: 3 x 10
3. Bent-over row: 3 x 10
4. Chest press: 3 x 10

1. Goblet squat

Sets: 3 Reps: 10

• Stand with your feet shoulder-width apart, toes pointing out, holding the weights in front of your chest.
• Inhale as you bend your knees and push your hips back to slowly lower.
• Pause when your thighs are parallel to the floor.
• Exhale as you push through your feet to stand.

Trainer tips: Imagine you’re lowering yourself into a chair when you squat. Move slowly, taking two seconds to lower and keep your center of gravity over your heels throughout.

2. Shoulder press

Sets: 3 Reps: 10

• Stand with your feet shoulder-width apart, holding a pair of dumbbells by your shoulders with palms facing forward and elbows out to the sides.
• Engage youre core then exhale as you push the dumbbells overhead, straightening your arms.
• Pause for one second.
• Inhale as you slowly lower the dumbbells back to the start

3. Bent-over row

Sets: 3 Reps: 10

• Stand with your feet hip-width apart, core engaged, holding dumbbells by your sides.
• Engage your core and, keeping a flat back and shoulders pulled back throughout, hinge forward at your hips to lower your torso toward the floor to roughly 45°.
• Exhale as you bend your elbows to pull the weights up to your waist, squeezing your shoulder blades together.
• Pause for one second.
• Inhale as you slowly lower the weights.

4. Chest press

Sets: 3 Reps: 10

• Lie on your back with your knees bent and feet flat on the floor, holding dumbbells by your chest, with your elbows bent and upper arms on the floor.
• Exhale as you push the weights straight up.
• Pause for one second.
• Inhale as you lower the weights back the start.

When we exercise, we often focus on either muscle strength, aerobic fitness or mobility, but there’s another aspect of our physical health that becomes increasingly important as we age—our bones.

While bone health might not get the same attention, it’s every bit as vital to our long-term health, explains personal trainer Kate Rowe-Ham, founder of Owning Your Menopause, who was diagnosed with osteopenia, the early stage of bone loss that occurs from middle age onwards.

Bone density naturally declines with age, particularly for women around menopause. “That makes us more prone to fractures and injuries, especially in the hips and spine,” says Rowe-Ham.

It’s estimated that one in three women and one in five men over 50 break bones due to osteoporosis, “but the right kind of exercise can make a huge difference,” says Rowe-Ham. “It’s one of the most effective ways to protect and even rebuild bone strength.”

How? Bones are living tissue that break down and rebuild, she explains. “If they’re not challenged, that rebuilding process slows. When we lift, push, pull or jump, we create stress in a beneficial way. This loading signals the body to strengthen the bone in response.”

Many of us are now aware that resistance training is beneficial for our bones, but impact and balance training play a crucial role, too. As does generally adding variety to your fitness routine, according to Rowe-Ham. “Bones respond best to different types of stimulus, so a mix of strength, weight-bearing and even plyometric movements is ideal.”

Below, Kate Rowe-Ham shares her favourite exercises for strengthening bones.

Resistance training

1. Squat

“The classic squat is one of the best things you can do for your bones,” says Rowe-Ham. “It loads the hips, legs and spine, the areas most vulnerable to bone loss and helps maintain functional strength for everyday movement.”

How to do it:

• Stand with your feet shoulder-width apart.
• Keeping your chest facing forward, bend your knees and hips to lower slowly, as if sitting back into a chair.
• Pause when your hips reach knee-height, or as low as your mobility allows.
• Drive through your heels to return to standing.
• Add weights once this movement feels easy.

2. Deadlift

“Deadlifts strengthen the entire back of the body and are particularly effective for improving bone density in the spine and hips,” explains Rowe-Ham. “They also enhance posture and core strength.”

The most well-known type of deadlift is lifting a barbell from the floor, but a great place to start is the Romanian deadlift, described below.

How to do a Romanian deadlift:

• Stand with your feet hip-width apart, holding dumbbells in front of your thighs with your palms facing you.
• Engage your core and, keeping your back flat and a slight bend in your knees throughout, hinge forward at your hips and push your hips back to lower the dumbbells down your body.
• Pause when you feel a slight stretch in your hamstrings.
• Drive through your heels and push your hips forward to return to standing.

Start with light dumbbells and focus on perfecting the hip hinge movement.

3. Overhead press

“This move strengthens bones in the arms, shoulders and upper spine—areas that often lose density, in particular for women after menopause,” says Rowe-Ham.

How to do it:

• Stand with your feet shoulder-width apart, holding dumbbells at shoulder height, palms facing forward and elbows out to the sides.
• Engage your core and press the weights straight overhead until your arms are fully extended, making sure you’re not arching your back.
• Lower with control, keeping your ribs down and core tight.

4. Resistance band row

“This exercise targets the spine, another key area for women. Rows strengthen the upper back and shoulder stabilisers, supporting posture and protecting against spinal compression,” says Rowe-Ham.

How to do it:

• Attach a resistance band to a secure anchor point in front of you at chest height, holding the band in both hands with your elbows slightly bent.
• Pull the band back until your elbows are in line with your torso.
• Squeeze your shoulder blades together, then slowly extend your arms to return to the start.

5. Step-up

“Simple but effective, step-ups mimic everyday movement patterns while targeting the hips and thighs,” says Rowe-Ham. “They improve both balance and bone strength.”

How to do it:

• Place your right foot on a sturdy step or bench.
• Drive through your right heel to straighten your leg and bring your left foot onto the bench.
• Step down with your left foot, lowering as slowly as possible.

6. Deficit calf raise

“Don’t underestimate the power of simple movements,” says Rowe-Ham. “Rising onto your toes and lowering your heels creates small, repetitive stresses through the feet and shins, helping to strengthen bones that often weaken with age. They’re a great quick win.”

How to do it:

• Stand with your feet hip-width apart on a step, weight evenly distributed across the balls of your feet and your heels off the edge.
• Lift your heels and rise onto your toes.
• Pause briefly, then slowly lower your heels as far as you can—they should be lower than your toes.

Plyometric training

Short bursts of impact exercise, such as small hops, squat jumps or skipping, can stimulate bone growth by applying quick bursts of powerful force. “Research indicates that even brief, high-impact sessions can enhance bone density in pre-and postmenopausal women,” says Rowe-Ham. “Start small and build gradually.”

How to do it:

• Small hops: Stand tall and perform 10-15 gentle hops on the spot, landing softly through the balls of your feet.
• Squat jumps: Lower into a squat, then drive up powerfully to jump, landing softly and immediately lowering into the next rep. Aim for 8-10 controlled jumps.
• Skipping: Skip for 1-2 minutes at a comfortable pace, resting as needed. Gradually build up over time as your joints adapt.

Weighted walking

Walking, particularly outdoors, is great for your sense of wellbeing and cardiovascular fitness, but to really benefit bone health, Rowe-Ham says that it helps to add some load. “Wearing a light rucksack or weighted vest increases the impact on the legs and hips, turning a walk into a bone-building workout.”

On your next walk, she also recommends varying your pace by alternating brisk walking with light jogging or uphill bursts. “This creates changes in impact that encourage bone adaptation,” she explains. “Bones thrive on variety, getting stronger when they’re challenged in different ways.”

Balance training

Not every bone-friendly exercise requires heavy weights or impact, Rowe-Ham points out. “Balance training helps prevent falls, which is just as important as improving bone density. Tai Chi, yoga and single-leg exercises all enhance stability and coordination.

“Bone health isn’t about doing one thing perfectly—it’s about doing a mix of things consistently. Combining strength training, impact and balance work gives your bones the stimulus they need to stay strong and responsive,” she continues. “And it’s never too late to start. By building the right foundations now, you’re investing in a more mobile, independent and confident future.”

We have plenty of routines that help develop balance. Try these three balance exercises to start with.

As I navigate a quite frankly wild range of perimenopause symptoms, I’m realizing that many of the niggles I thought were muscle soreness could actually be down to hormonal changes.

I thought my recent hip pain might be down to my newfound love of Pilates, but when I spoke to menopause expert Dr Louise Newson, she explained it could be a symptom of perimenopause and menopause.

“Muscle and joint pains in general are very common symptoms during perimenopause and menopause,” says Newson, founder of the Balance menopause app and host of The Doctor Louise Newson Podcast.

“Our hormones, progesterone, estradiol and testosterone all work to reduce inflammation throughout our bodies, especially in our muscles and joints. So when levels of these important hormones are reduced, there is more inflammation in our muscles and joints leading to worsening pain.

“Some women can experience hip pain due to osteoarthritis, which is more common in menopausal women..

“There is also something called greater trochanteric pain syndrome (sometimes called trochanteric bursitis), which is a painful condition affecting the outer disc of the hip and thigh. This is often triggered by low hormone levels.”

Interestingly, how we experience pain can also be affected by hormonal changes.

“Another thing that can happen is that the hormones progesterone, estradiol and testosterone can affect our pain receptors. This basically means that when levels of these hormones are low, our perception of pain changes, and we can feel it more than usual.”

I spoke to Newson in more detail about these symptoms and what can help reduce them. We know exercise is essential so I also asked pelvic floor therapist Dr Amanda Neri to create a hip mobility workout, featured below.

Five movements to help manage stiff hips

For movement to help manage menopausal hip pain, pelvic floor therapist Dr Amanda Neri has created this routine.

You will need a mini or loop resistance band (like this set on Amazon) for this sequence. Neri recommends doing this routine three to five times a week for best results.

1. Hip controlled articular rotation

Sets: 1 Reps: 6 each direction, each side

“This helps maintain hip mobility and works on the deeper hip rotators and hip joint capsule, which surrounds the joint and connects the pelvis to the femur, providing support and stability,” says Neri.

• Start on your hands and knees, with your shoulders over your wrists and your knees under your hips.
• Keeping a 90° bend in your knee and moving from your right hip throughout, bring your right knee toward your chest, then out to the side as close to hip height as your mobility allows, then behind you, and finally back to the start, with your right knee under you right hip.
• Reverse the movement, raising your right knee behind you, out to the side, to your chest and then to the start.
• Complete all your reps on one side, then switch sides.

Form tips: Keep your foot flexed as you rotate, for maximum engagement and deeper range of motion.

2. Figure-4 stretch

Sets: 2 Time: 30-60sec each side

“This stretch helps relax glute muscles that may be sore or tight,” says Neri.

• Lie on your back with your knees bent and feet on the floor.
• Place your right ankle on your left thigh, just above your left knee.
• Take hold of the back of your left thigh in both hands and gently pull your left leg to your chest—you should feel a stretch in your right buttock.
• Hold for time, then repeat on the other side.

3. Pelvic tilt glute bridge

Sets: 2 Reps: 10

“The posterior pelvic tilt helps with pelvic and lower back mobility, while the bridge helps isolate and strengthen glutes and hamstrings,” says Neri.

• Lie on your back with your knees bent and both feet flat on the floor.
• Rotate your hips back into a pelvic tilt by pushing your back into the floor.
• Squeeze your glutes as you slowly lift your hips.
• Hold for 1-2 seconds then return to the starting position slowly.

Form tips: “For the pelvic tilt, think about tucking your tail between your legs,” says Neri. “Squeeze the glutes and lift the hips off the floor, making sure to not flare the rib cage out. Exhale as you lift.”

4. Side-lying leg raise

Sets: 2 Reps: 10 each side

“I recommend this to clients as it strengthens outer glutes that help stabilize us when walking, exercising and balancing,” says Neri.

• Lie on your side with your legs extended, resting your head on your arm.
• Bend your lower leg, keeping the leg on top straight.
• Slowly raise your upper leg just past hip height, squeezing your glutes.
• Keep your toes pointing down.
• Slowly lower to the start.

Form tips: Keeping your foot flexed (toes pointing down) activates the leg muscles for better results.

5. Standing clamshell

Sets: 2 Reps: 8 each side

“This really helps strengthen and stabilize hips because it's done while standing,” says Neri.

• Stand facing away from a wall with your feet hip-width apart with a loop band around your thighs, just above your knees, and your hands on your hips.
• Shift your weight onto your right leg, and bend your left knee to lift your left foot behind you, placing the sole of your foot on the wall at knee height. Your knees should be together. Hold onto a chair or stable surface for support if needed.
• Keeping your left foot on the wall, raise your left knee out to the left side, working against the resistance of the band.
• Pause, then reverse the movement to bring your knees together.
• Complete all the reps on one side, then switch sides.

Dealing with the physical and mental changes of menopause can feel like an uphill battle, but small wins can make all the difference. I’ve found that eating well has helped me manage some of my perimenopausal symptoms, and I always feel better when I have time to cook from scratch.

I spoke to menopause nutritionist Karen Newby, author of The Natural Menopause Method Cookbook, to see what she recommends for women in this transitional period.

“Often my advice is actually to eat more—especially at breakfast and lunch. This helps to fuel our brain and body when we need the energy—in the daytime—not at the end of the day when it’s more likely to be laid down as fat.

“So many of us don’t eat breakfast, which can mean that we are hanging off our hormones or caffeine all morning—this is when irritability can get worse!

“More protein-rich foods with every meal and snack are also important, as is fiber. Something like 90% of us don’t get enough.”

In her new book, The Natural Menopause Method, Newby has created recipes that she says can help ease some of the most common issues her clients are dealing with.

“The eight symptoms I have created recipes for are aches and pains, brain fog, exhaustion, hot flushes, irritability, overwhelm/anxiety, sleep deprivation and menopausal weight gain,” says Newby.

Scroll down to try three of Newby’s recipes, as well as hear the top four food types she says every midlife woman should be eating more of.

Beef pho recipe

“This is a dish designed for our joints due to the collagenous broth and the analgesics (natural painkiller properties) from the aromatics (cloves, fennel and star anise),” says Newby. “The broth also contains the amino acid glycine, which is important for cartilage, ligaments and tendons.”

Prep time: 15min Cook time: 40min

Ingredients

• 4 star anise
• ¼tsp whole cloves
• 1½tsp coriander seeds
• ¼tsp black peppercorns
• 2 cinnamon sticks
• 1 banana shallot, halved lengthways
• 35g (1¼oz) peeled fresh ginger, 25g (1oz) sliced lengthways and the remainder finely grated
• 2 garlic cloves, roughly crushed with the flat side of a knife
• 2 celery sticks, roughly chopped
• ½ fennel bulb, roughly chopped
• 1 carrot, peeled and roughly chopped
• 1.5 litres (2¾ pints) home-made or good-quality shop-bought beef (or chicken) broth/stock, hot
• 2tbsp fish sauce (nam pla)
• 3tbsp tamari
• 90ml (3floz) lime juice, approximately 3-4 limes
• 400-500g (14oz-1lb 2oz) beef steak (rump or fillet), cut into ½cm (¼in)-thick slices
• 400g (14oz) dried rice noodles
• 1tbsp olive oil
• 1 lime, quartered into wedges, to serve
• Hoisin or chilli sauce or sriracha

Garnishes (any or all of the following)

• 50g (1¾oz) beansprouts
• 4 radishes, thinly sliced
• 15g (½oz) fresh Thai (or regular basil leaves)
• 10g mint leaves

Method

1. Add the spices, shallot and sliced ginger to a large saucepan and dry-fry over a medium heat for two minutes, until lightly toasted and smelling fragrant.
2. Add the garlic, celery, fennel and carrot and continue to dry-fry for another two to three minutes.
3. Add the hot broth/stock and bring to a gentle simmer.
4. Add the fish sauce and 2 tablespoons of the tamari, cover and cook slowly for about 40 minutes.
5. Meanwhile, mix the remaining tablespoon of tamari with 2 tablespoons of the lime juice and the grated ginger. Pour this over the beef slices in a dish, stir to coat, then set aside to marinate until needed.
6. Cook the noodles according to the packet instructions and then cool under cold running water to stop them from cooking further or sticking. Divide between four bowls.
7. Add the olive oil to a frying pan and, once hot, add the marinated steak slices. Fry over a medium-high heat for 2-3 minutes, turning so that both sides are seared.
8. Place the steak slices on top of the noodles, to rest and wait for the broth to finish cooking.
9. Just before serving, add the remaining lime juice to the broth and then, pouring through a sieve (to catch the aromatics), ladle it into the bowls.
10. Serve with whatever garnishes you like, along with a wedge of lime and some hoisin or chilli sauce or sriracha to dip the beef into.

My verdict: This dish has a fair few ingredients so while it’s a modified version of a traditional pho—you only cook the broth for 40 minutes instead of hours—it may feel a little complicated for amateur cooks. I couldn’t find banana shallots in my local grocery store so I substituted with half a white onion. I like my pho a little spicy so I added some dried chilli flakes to the broth as well as some fresh mint at the end and a generous squeeze of sriracha sauce to give it a real kick.

Thai coconut chicken soup recipe

“Low in carbohydrates and high in protein to support a drip-feed of energy to minimize snacking, this delicious, healthy soup can be eaten on its own or with the addition of courgetti (strips of zucchini) or some cooked prawns,” says Newby. “The chicken is also a great source of B vitamins for energy, and coconut milk provides caprylic acid, known for its anti-microbial effect in the gut.”

Serves: 4 Prep time: 15min Cook time: 40min

Ingredients

• 1½tbsp coconut oil
• 25g (1oz) peeled fresh ginger, cut lengthways into ½cm (¼in)-thick slices
• 2 lemon grass stalks, lightly bruised and cut into 5cm (2in)-long pieces
• 10 makrut lime leaves, rolled up and thinly sliced
• 20g (¾oz) fresh coriander, stems chopped into 2cm (¾in) pieces, leaves roughly chopped
• 2 banana shallots, roughly chopped
• 800ml (28fl oz) chicken stock
• 400ml (14fl oz) can coconut milk
• 400g (14oz) skinless, boneless chicken thighs, cut into 2-3cm (¾-1¼in) pieces
• 100g (3½oz) white button mushrooms, sliced ½cm (¼in) thick (or halved)
• 100g (3½oz) beansprouts, French beans cut into thirds or mangetout (depending on the season)
• 2tbsp lime juice
• 2tbsp fish sauce (nam pla)
• 1 red chilli, thinly sliced (optional)
• 1 lime, quartered into wedges, to serve

Method

1. Add the coconut oil to a large saucepan and place over a medium heat.
2. Once melted, add the ginger, lemongrass, lime leaves, coriander stems and shallots and cook for about three minutes, stirring from time to time.
3. Pour over the stock, bring to the boil, then reduce to a simmer, cover and cook for 10 minutes.
4. Next, strain the stock through a colander into a heatproof bowl (do not throw away the liquid!), pressing the aromatics to extract as much flavour as possible.
5. Return the liquid to the saucepan (the aromatics can now be discarded) and add the coconut milk, chicken pieces and mushrooms.
6. Bring to a simmer, then cover and cook for 15 minutes, until the chicken is cooked through.
7. Add the beansprouts, French beans or mangetout, cook for a final 3-4 minutes and then stir through the lime juice and fish sauce.
8. Serve as is, or on top of cooked noodles, courgetti (strips of zucchini) or rice, with the red chilli (if using) and coriander leaves sprinkled on top, plus a wedge of lime alongside for everyone to squeeze over their own bowl.

My verdict: This is a fairly easy recipe to make and it tastes really good, too. I like to brown the meat a bit for extra flavour rather than poach it, so I fried the chicken thighs at the same time as the ginger. If you don’t like meat on the bone you could substitute the thighs for chicken breast. As with the pho, I used white onion in place of banana shallots.

Iron lady smoothie recipe

“Kale, beetroot, parsley and spinach are some of the best sources of iron and are also high in vitamin C to help its absorption,” says Newby. “They are also great sources of magnesium. Beetroot contains nitrates, which convert to nitric acid in the body, and this helps with circulation.”

Serves: 2 Prep time: 10min

Ingredients

• 2 raw beets, washed, trimmed and roughly chopped
• 6 carrots, roughly chopped
• 3 kale leaves
• 20g/¾oz fresh ginger (no need to peel)
• 25g/1oz fresh parsley
• 80g/3oz baby (or regular) spinach
• 140g/5oz cucumber, roughly chopped

Method

1. Put all the ingredients into your juicer or blender and juice.
2. Pour into two glasses and serve.

My verdict: This is a really fresh and hearty smoothie that feels as healthy as it tastes. Beware—the beets can stain so be careful when pouring it out into a glass, and try your best not to spill any on yourself or it will look like a massacre! I liked how easy it was to make, and it was still good with regular instead of baby spinach, and I couldn’t find parsley in the supermarket so I omitted that, too.

These recipes are taken from The Natural Menopause Method Cookbook by Karen Newby (Pavilion Books), out now.

The four food types midlife women should eat more of

Newby says if midlife women do nothing else, they should prioritize these four food types to help ease menopause symptoms.

1. “Make friends with tofu for the phytoestrogens, which have a mild estrogen-like effect on the body (the hormone that fluctuates during menopause),” says Newby. “And if you don’t like tofu, then try tempeh, miso, edamame beans, organic soya yogurt or ground flaxseed and pulses like chickpeas, peppers and cruciferous vegetables including broccoli, cabbage, kale, Brussels sprouts, and cauliflower. Phytoestrogens can really help with hot flushes which occur far less in North Asian countries like Japan and China who eat a lot of soy and other plant sources of phytoestrogens.
2. “Eating more salmon is a great source of protein and for B6 to support progesterone synthesis and for omega 3 for its anti-inflammatory properties. Other omega 3 sources include sardines, mackerel, herring and vegan sources like linseed oil. Omega 3 can really help with morning stiffness as well as low mood.
3. “Nuts, especially walnuts for minerals, omega 3 fats and antioxidants like flavonoids to help with brain fog and cognitive health.
4. “Green leafy vegetables are good for iron, magnesium, vitamin C and calcium. And they are also a great source of fiber, which supports a healthy gut. Green leafy vegetables provide minerals to help us feel less exhausted.”

Balancing your hormones during the different stages of the menopause can feel a bit like a jigsaw puzzle of medication, exercise, nutrition and lifestyle changes. But there’s one thing you can do to help manage symptoms and that’s make sure you’re eating the right amount of fiber, says Dr Lena Rebecca Larsen from More Nutrition.

“As women move through midlife, their nutritional needs begin to shift and fiber becomes increasingly important,” says Larsen. “While overall calorie needs may decline slightly with age, the role of fiber becomes more critical—not just for digestion, but for maintaining heart health, blood sugar balance, weight stability and hormonal health.”

“During perimenopause, menopause and post-menopause, hormonal fluctuations—especially the decline in estrogen—can lead to changes such as slower digestion, higher cholesterol, increased insulin resistance and a greater tendency to gain weight, particularly around the midsection. Fiber plays a powerful role in supporting the body through these changes, helping to regulate many systems that become more vulnerable with age.”

Read on to find out more about how getting enough fiber can improve menopausal symptoms.

How does fiber help with menopause symptoms and overall health?

Fiber can ease menopausal symptoms and some of the health challenges that arise during perimenopause. The hormonal changes that come with menopause can cause a “cascade of effects on digestion, metabolism and inflammation levels”, says Larsen. “Fiber offers protection on several fronts—it helps to regulate bowel function, which can become sluggish due to slower gastrointestinal motility associated with reduced estrogen.

“Fiber supports the microbiome—the community of beneficial bacteria that influences everything from digestion to immunity to mood. As estrogen levels fall, microbial diversity can shift, potentially leading to increased inflammation or digestive discomfort. Fiber nourishes the gut microbiota, encouraging a more stable and health-supportive balance of bacteria.

“It also plays a key role in removing excess hormones—particularly estrogen [the levels of which can fluctuate dramatically before, during and after menopause]—from the body via the digestive tract, supporting hormonal balance.

“Fiber also supports blood sugar regulation, which is crucial as insulin sensitivity—how effectively your body responds to this hormone—often decreases during and after menopause.

“Fiber slows the absorption of glucose into the bloodstream, helping to reduce spikes and crashes that can affect energy, mood and appetite. This also contributes to a reduced risk of insulin resistance and type 2 diabetes, which increases during and after menopause.”

And that’s not all. Soluble fiber is known for improving heart health by binding with bile acids and cholesterol in the gut, helping to remove them from the body and lower LDL (bad) cholesterol levels. “Its anti-inflammatory effects and influence on the microbiome further support cardiovascular function,” says Larsen.

Finally, high-fiber foods are more filling and tend to be less calorie-dense, which, Larsen says, can “help with appetite control and maintaining a healthy weight—an increasingly common challenge as metabolic rate slows with age.”

How much fiber do women need?

Larsen told me that the daily fiber recommendation for women in the perimenopause is 25-30g, which falls to 21-25g (depending on calorie needs and health status) post-menopause.

“Women with specific health goals—such as managing cholesterol, improving blood sugar control or supporting weight loss—may benefit from intakes at the upper end of this range, or slightly beyond, if tolerated,” says Larsen.

How to get more fiber into your diet

One of the simplest ways to increase your fiber intake is to make a few strategic food swaps, says Larsen.

“Replace white bread with wholegrain, and add legumes such as chickpeas, lentils or black beans to each meal. Variety is key. Combining fibers such as psyllium husks and soluble fiber from corn will not only help you meet your daily intake, but will also feed different types of beneficial gut bacteria, helping to keep your microbiome robust.”

“Glucomannan is also a good choice given its solubility. As a natural fiber extracted from the root of the konjac plant, it can absorb up to 50 times its weight in water and so can support weight management by promoting fullness and reducing appetite.

“In addition, several scientific studies have shown it to have strong beneficial effects as a prebiotic, by changing the gut microbiota beneficially.”

“Glucomannan’s fiber complex also aids digestion and cholesterol control, important for heart and gut health during and after menopause, and may help reduce LDL (bad) cholesterol and mitigate against blood sugar spikes.”

But it’s important to increase your fiber intake slowly to avoid temporary uncomfortable side effects such as bloating, gas and abdominal cramping—particularly if water intake is low, explains Larsen.

“Fiber needs water to move effectively through the digestive system, so as it goes up, so should fluid intake. Plus, introducing fiber slowly over the course of a couple of weeks allows your digestive system to adjust and reduces the risk of discomfort. It also gives your gut bacteria time to adapt to the new food sources.”

Women with IBS, IBD, or other gastrointestinal sensitivities should increase fiber cautiously and consider the type they’re consuming. “Soluble fiber found in foods like oats, sweet potatoes, guar gum, acacia fiber, psyllium and soluble corn fiber is typically better tolerated than insoluble fiber, in wheat bran, raw cabbage, beans or lentils, which can irritate the gut in sensitive individuals,” says Larsen. “Consulting a dietitian is highly recommended in tailoring fiber intake to individual needs and tolerances.”

“Fiber plays an often underappreciated role in the broader picture of hormonal or peri- and postmenopausal health. It’s a cornerstone of a diet that supports graceful, healthy aging.

“In combination with regular movement, adequate hydration and stress management, a fiber-rich diet can empower women to feel more balanced, energetic, and well throughout midlife and beyond.”

I recently acquired a new personal training client in her 50s, who sought my help specifically because she’d been told her bone density was too low.

This is common during menopause; women also lose lean muscle and suffer from a wide range of symptoms, including brain fog, anxiety, and poor sleep.

One of the best ways to manage these health issues is to combine strength training with cardio.

Strength training helps keep bones strong, protects against osteoporosis and builds muscle, which we lose as we age. Cardio is good for your heart—which is negatively impacted by declining estrogen levels. It can also improve energy levels, boost calorie burn, and have a positive impact on your mood and sleep.

I’ve created this quick 30-minute strength and cardio workout to ease menopause symptoms. It’s joint-friendly, with no jumping movements, and easy to do from home—I certainly find it helps me manage my own symptoms.

How to do the workout

You will need a pair of dumbbells for this workout.

The moves:

• Knee drives
• Narrow to wide squat
• Knee lifts
• Weighted goblet squat
• Weighted squat and punches
• Weighted pullover and deadbug toe taps
• Bird dog zippers

Do each exercise for 45 seconds with 15 seconds rest, completing four rounds in total. Take 30-60 seconds rest between sets.

Aim to do this workout three times a week, more if you can. Each session only needs to be 30 minutes.

It’s not about how long you exercise—it’s about consistency. I’d also recommend doing some mobility training every week to keep joints happy and healthy.

Exercise explainers

Knee drives

Sets: 4 Time: 45secs

• Stand with feet hip-width apart.
• Lean forward slightly as you step your left leg back and put your arms straight out in front.
• Drive your knee towards your chest, bending your elbows and pulling your arms towards your torso.
• Tap your foot back behind you and extend your arms out straight again.
• Repeat for 45 seconds and alternate legs with each round of exercise.

Narrow to wide squat

Sets: 4 Time: 45secs

• Stand with feet hip-width apart.
• Push your hips back and lower into a narrow squat.
• Push through your heels and squeeze your glutes to stand.
• Step to the side with your right leg then lower into a wide squat.
• Push through your heels and come back to a narrow standing position.
• Lower into a narrow squat then stand.
• Step your left leg to the side and lower into a wide squat.
• Push through your heels and come back to a narrow standing position.
• Repeat at pace for 45 seconds.

Knee lifts

Sets: 4 Time: 45secs

• Stand with feet hip-width apart and hands behind your head.
• Raise your left knee and bring your right elbow towards it, then lower the leg.
• Lift the right knee up, bringing your left elbow down at the same time.
• Alternate sides for 45 seconds.

Weighted goblet squat

Sets: 4 Time: 45secs

• Stand with feet slightly wider than hip-width apart and toes turned out.
• Hold the dumbbell under your chin, with both hands grasping one end.
• Lower down into a squat, keeping your knee tracking in the same direction as your toes.
• Squeeze the glutes and drive through the heels as you stand.

Weighted squat and punch

Sets: 4 Time: 45secs

• Stand with legs hip-width apart, holding two dumbbells at your chest.
• Lower into a squat with weights close to your body.
• Stand and punch with your right hand and then left.
• Bring the weights back to your chest and lower into another squat.
• Repeat for 45 seconds.

Weighted pullover and deadbug toe taps

Sets: 4 Time: 45secs

• Lie on the floor with your legs in the air, knees bent at 90°.
• Hold a dumbbell with both hands and extend your arms, so that the weight is above your chest. Ensure your back is pushed into the mat so it’s not arching.
• Slowly lower the weight back over your head toward the floor, at the same time as you tap your right foot on the floor.
• Lift the right foot back up to the starting position as you bring the weight back over your chest.
• Then lower the weight back down as you tap the other foot to the floor.
• Return to the start position and repeat for 45 seconds.

Bird dog zippers

Sets: 4 Time: 45secs

• Start on your hands and knees with your shoulders over your wrists and hips over your knees.
• Brace the core as you extend your right arm in front and the left leg behind you. Your arm and leg should be in a straight line while keeping your hips and shoulders parallel to the floor.
• Bring the elbow and knee of the extended right arm and left leg toward each other to touch under the torso. Then extend the arm and leg again.
• Come back to your starting position, swaps sides and keep alternating for 45 seconds.

Going through the menopause triggers a lot of changes in your body, including your pelvic floor.

This is the group of muscles that sit at the base of the pelvis. They play an important role in bladder and bowel function, which means a weak pelvic floor can lead to incontinence and affect sexual function.

Women are more likely to be impacted by pelvic floor issues than men. One small study shows that 83% of women between the ages of 18 and 59 have experienced a pelvic floor health symptom in the past year.

"We naturally have weaker pelvic floors than men and that's because of hormones, the shape of our bones, and we tend to have slightly wider pelvises,” explains Leanne O’Brien, specialist pelvic health physical therapist at Ten Health. “It's also because the [female] pelvic floor has two holes in it,"

And when you reach menopause, the risk of pelvic floor issues can become even greater.

"Our pelvic floors are naturally not as strong or resilient as men's. As we get older, particularly when we hit perimenopause and menopause, the pelvic floor will get weaker," says O'Brien.

Why does the pelvic floor get weaker during menopause?

Hormone health can have a big impact on the pelvic floor. In fact, for women, the pelvic floor can become weaker week-to-week, as a result of the menstrual cycle.

"The pelvic floor is quite reliant on estrogen, and that's why our pelvic floor strength and control can change slightly, or it can appear to change, with our monthly hormonal cycles," explains O'Brien.

"When we hit menopause, the estrogen levels drop very low, and because the pelvic floor is quite reliant on estrogen—it has lots of estrogen receptors—the pelvic floor gets weaker and it becomes less responsive. It becomes less active and it is not as quick to respond."

What are the symptoms of a weak pelvic floor during menopause?

O'Brien explains that stress urinary continence is a common issue associated with menopause.

"If we cough, sneeze or jump up and down, that [pelvic floor] reaction is not quite so quick."

According to O'Brien, many people ignore stress incontinence at first, which becomes a problem when perimenopause and menopause starts.

"Estrogen levels eventually start to really drop [during menopause] which can cause a worsening of those symptoms, and it's far more difficult to treat during menopause, because the pelvic floor isn't as responsive," she explains.

Prolapse is another common pelvic floor issue associated with menopause.

"Prolapse is really common, particularly with people that are considered hypermobile who are more likely to suffer from stress incontinence and pelvic floor related issues."

How to strengthen your pelvic floor during menopause

Prevention is better than cure. Even if you're not menopausal yet, strengthening your pelvic floor could help reduce your risk of symptoms arising in the future.

But don't worry if you're already peri-menopausal or menopausal and experiencing symptoms, you can still do things to help.

"We know for a fact that as we get older, we get weaker, so unless we do something to counteract that, that process is going to happen," O'Brien says. "This is why strength training, in particular for the older population, is becoming more and more popular.

"The stronger you are, the more mobile you are, the better your quality of life is likely to be into your older age, because we have to work against this natural tendency for us to get weaker as we get older—and that also includes the pelvic floor," she adds.

There are specific exercises you can do to strengthen the pelvic floor, such as Kegels, and it's also important to strengthen the muscles surrounding your pelvic floor, including the glutes and the abdominal muscles.

Take a look at O'Brien's workout to help you strengthen your pelvic floor—it requires no equipment and can be done at home.

Incorporating a menopause strength workout into your fitness regime can help build muscle and protect your bones, improve your metabolic rate, and boost cardiovascular health and overall wellbeing.

The menopausal transition affects each woman uniquely and in various ways: the body begins to use energy differently, fat cells change, and you may gain weight more easily. 

Changes in bone or heart health, body composition or physical function are common, which is why many people take the best menopause supplements to try and ease the symptoms and support their bodies. 

However, maintaining muscle as you get older helps improve your mobility, supports the muscles around your bones, and increases your metabolism (the amount of energy you burn throughout the day), which naturally slows as you age. 

But there's a common perception that you need to head to the gym and lift heavy weights to get the benefits. Fortunately, that's not the case, as this eight-move menopause strength workout is easy on your joints, and you only need two dumbbells to get started. 

Eight-move menopause strength workout

For this menopause strength workout you will need a mat, a set of dumbbells, and some water. If you're new to weights training, aim for 4-6lbs, up to 10lbs if you've done some training before, and 18lbs if weights are a regular part of your routine—but choose what feels most comfortable for you.

There are eight moves in this routine, and the aim is to do them for 30 seconds each, resting for 40 seconds between exercises. To increase the intensity, gradually reduce the break down to 30 or 20 seconds. 

To get the most from your training and avoid injury, it's vital to learn how to warm up before a workout. This gets oxygen to your muscles to prepare them for the session ahead and may reduce the effects of delayed-onset muscle soreness (DOMS). 

Menopause strength workout plan

1. Weighted squat thrusters

Muscles worked: posterior chain (legs, back, glutes), abs, pectorals, hamstrings, triceps, shoulders (deltoids)

• Position the dumbbells just above your shoulders, elbows in tight, and engage your core.
• Take your feet shoulder width apart. Keeping your back straight, squat down as if you were sitting into a chair. From this position, press up through the heels, squeeze the glutes and use your leg and butt muscles to drive back up.
• As you drive up, push the weights straight up above your head. Bring them back down as you squat again, then repeat this movement for 30 seconds. Keep your chest and head lifted at all times.

2. Dumbbell goblet squat pulse

Muscles worked: quads, calves, hamstring, hip flexors, outer thighs, glutes, shoulders, chest, triceps, and back

• Hold the weight in front of your chest with palms facing up around the weight and the dumbbell in a vertical position.
• With feet shoulder width apart, pull shoulder blades back together tightly to maintain neutral spine throughout the exercise. Keep your chin tucked in. 
• Hinge at the hips and drive back into a squat position. The dumbbell should remain under your chin. Hold that low squat position and then pulse (tiny movements up and down) for 30 seconds.

3. T-shape lateral arm raise to front raise squats

Muscles worked: quads, glutes, calves, hamstrings, erector spinae (controls rotation of the back), rectus abdominis (the six-pack muscle), internal and external obliques, deltoids (shoulders), biceps, pectoralis major, and trapezius (upper back) 

• Start with feet hip-width apart and the weights in your hands by your side. Raise your arms to the side into a T-shape as you squat down. To squat, hinge at the knees, lower down and push back with the hips as if you are sitting back into a chair. Keep your knees stacked over your toes.
• Bring your arms into a front raise position, still in your lower squat position, then push through your heels to power back up to standing squeezing your glutes at the top. As you come up from the squat, lower your arms back down to your thighs. That’s one repetition. 

4. Curtsy lunge to bicep curl

Muscles worked: gluteus medius, hip adductors, quads, hamstrings, and biceps

• Stand with feet hip width apart with weights in your hands by your side, shoulders back, and core engaged. Putting your weight into your right foot, step back and around with your left foot—almost as if you’re curtsying. Lunge down, bending your knees and lowering your hips until your left thigh is nearly parallel to the floor. 
• Hold that low curtsy lunge position as you do a bicep curl—with palms facing upward, slowly curl the weight up bending at the elbow, keeping elbows close to your body. Slowly lower the weight to the starting position.
• Once you’ve done your bicep curl, begin to straighten your right leg, pushing up through your heel, and returning your left foot to the starting position. That’s one repetition. Swap legs and repeat on alternate legs.

5. Dumbbell halo

Muscles worked: deltoids, trapezius, pectorals, and triceps

• Hold one dumbbell sideways and bring it to eye level. 
• Rotate the weight in a circular motion anti-clockwise around your head in a circle like a halo. 
• Repeat in the opposite direction then change again. Alternate like this for 30 seconds.

6. Overhead triceps extension

Muscles worked: triceps

• You can do this exercise standing or seated on a chair or exercise bench. 
• Hold a single dumbbell and make a triangle with your hands so the palm is on the top of the weight. Bring the weight over your head and keep your elbows glued to your ears, pointing forward not flared out to the sides. 
• Bring the weight down and as you come up, squeeze your triceps. Keep your core tight and come down low. 

7. Weighted toe touches

Muscles worked: transverse abdominis, rectus abdominis, and obliques

• Lie on your back with your core braced, back flat on the mat, and your legs straight in the air.
• Hold a single dumbbell sideways directly over your chest with arms fully extended.
• Take a deep breath then exhale as you use your stomach muscles and core to reach towards your toes with the weight. Slowly and with control lower to start position. That’s one repetition. 

8. Weighted side-lying leg raise

Muscles worked: gluteus maximus

• Lie on your right side on the floor with your body in a straight line, hips, knees and feet stacked on top of each other.

• Put your arm straight on the floor under your head or bend your elbow and hold your head in your hand. 

• The other hand will be holding a dumbbell, which you will place at the top of your left thigh.

• As you exhale gently raise your left leg off the lower one and push against the resistance of the weight. Inhale and lower the leg back down with control to meet the right leg. Repeat for 30 seconds on one side then swap legs.

There are many ways to help support your body to reduce the effects of menopause symptoms. Strength workouts like this develop muscle, work your core, improve your balance, and promote circulation, while also boosting your metabolism. 

But it's worth also coupling this routine with a menopause abs workout to directly target your core. This will increase the effects, helping stabilize your body, and bosot your performance in the strength workout. 

Plus, you can also include a few menopause HIIT workout sessions if you want to focus on your cardio fitness and burn fat. It's also important to focus on how you eat as well, and this menopause diet plan gives your body all the nutrients you need. 

Strengthening your core with a menopause abs workout is an excellent way to support your body as you go through this stage in your life. Working your core helps connect your upper and lower body and promotes circulation to make everyday tasks easier. 

As a personal trainer focused on helping women navigate menopause, I know many women's bodies change shape and size, often because of hormonal changes, like a drop in estrogen levels, that affect the way our bodies store fat. 

This is why some women opt to take the best menopause supplements to make the transition a bit less fraught and to manage menopause symptoms. But using this menopause abs workout can also help keep you active and develop functional muscle around your midsection. 

Plus, if you alternate it with a menopause HIIT workout, you can build a stronger core, strengthen the connection between your body and mind, protect your heart, and boost your metabolism to manage menopausal weight gain. 

Seven-move menopause abs workout

Before starting this bodyweight routine, you want to ensure you've done a warm-up to get the blood flowing to your muscles and stretch them ready for your workout. 

Once your muscles are primed, you can dive into the main menopause abs workout. This should take 15 minutes and is designed to work your core muscles to boost your balance, improve your stability, and promote circulation. 

The aim is to do three sets of each exercise, working intensely for 30 seconds followed by a 30-second rest before starting the next move. However, as the plank jacks can be quite challenging, start with 20 seconds and gradually increase the time.

Menopause abs workout plan

1. Walking lunges

Muscles worked: glutes, quads, hamstrings, core.

• Start with your feet shoulder-width apart, hands by your sides or on your hips.
• Step forward with your right leg, putting the weight into your heel.
• Bend the right knee, lowering it until your shin is parallel with the floor.
• Hold here for a moment, before repeating the movement with your left leg, keeping your right leg in place. 
• Pause once your left leg is parallel to the floor in a lunge position.
• Repeat this movement as if walking forward as you lunge, alternating legs. 

2. Squat into lateral (side) leg raise

Muscles worked: glutes, quads, hamstrings, calves, hip flexors, abductors, and core.

• Stand with your feet shoulder-width apart and knees slightly bent.
• Lower yourself into a squat position with your thighs parallel to the floor and hold this position for a moment. 
• Push through the heels and squeeze your glutes as lift out of the squat to the starting position. 
• Transfer your weight to your left leg and raise your right leg out to the side.
• Hold for a moment before returning this leg to the ground. Keep your leg as straight as possible during the lift.
• Repeat this movement but transfer your weight to your right leg and raise your left leg out to the side.
• That's one repetition. Continue this pattern for 30 seconds. 

3. Russian twist

Muscles worked: core (obliques, rectus abdominis, transverse abdominis), hip flexors, latissimus dorsi (lower back).

• Sit on the floor with your knees bent and feet in front of you. 
• Reach your arms straight out in front as you lean back until your hands reach your knees, creating a V-shape with your torso and thighs. 
• Engage your core as you lift your feet off the floor and bring your hands together in front of your chest.
• Use your abdominal muscles to twist to the right, back to the center, and then to the left. 
• That is one repetition. Repeat for 30 seconds.

4. Single leg lowers

Muscles worked: core (abdominals and obliques), hips.

• Lie on the floor with your back pushed into the mat and legs straight up in the air.
• Engage your core and keep your head and shoulders on the floor with your arms by your side.
• Lower one leg towards the floor slowly until it's almost touching the floor, with the opposite leg still in the air.
• Pause and return your leg to the start position and swap legs. 
• Repeat and alternate legs for 30 seconds.

5. Inchworm

Muscles worked: core (abdominals and obliques), hamstrings, triceps, upper back, lower back, deltoids (shoulders).

• Stand with your feet shoulder-width apart, then fold forward with straight legs and reach your arms down towards the floor, keeping your head in line with your back. 
• If you find it tough to reach the floor, you can bend your knees slightly as you fold forward.
• Slowly walk your hands away from your feet, extending your body into a high plank position.
• Slowly walk your hands back to your feet, getting your body back to an upright position.
• Repeat this movement for 30 seconds.

6. Plank shoulder taps

Muscles worked: core (abs and obliques), glutes, deltoids (shoulders), upper body.

• Start in a high plank position with your wrists under your shoulders and feet shoulder-width apart. 
• Lift one hand off the ground, tap the opposite shoulder, then return it to its original position and swap hands.
• Repeat on alternate sides for 30 seconds.

7. Plank jacks

Muscles worked: pectorals, core (rectus abdominis, transverse abdominis, and obliques), deltoids (shoulders), back, and arms.

• Start in a high plank position with your shoulders over your wrists and legs hip-width apart.
• Brace your core by pulling in your tummy and jump both feet out to the side and then back to the center.
• Repeat this pattern for 30 seconds.

Using core strengthening exercises like these can be a great way to support your body — through menopause and every day life. Your core is a section of mid-body muscle that connects your upper and lower body. 

Because of this central role, it plays a crucial part in your balance, stability, and performance in functional tasks like lifting heavy objects, reaching up to a top shelf, or carrying bags and groceries. 

If you want an alternative way to strengthen your mid-section, which includes your abdominal muscles, you could invest in one of the best ab rollers. These portable, lightweight wheels won't break the bank but help work your core. 

Taking on a menopause HIIT workout can be a great way to manage symptoms like fatigue and low mood. You may feel more tired than usual, which makes it hard to find time, motivation, or energy to exercise. 

You don't need to spend hours at the gym to see the benefits of regular exercise, though, as high-intensity interval training (HIIT) routines are an effective companion to the best menopause supplements and only take 15 minutes. 

The aim is to train in short, intense bursts with minimal rest. This helps raise your heart rate, work muscles all over your body, and boost your metabolism, all wrapped in a time-efficient routine to boost your energy and improve your wellbeing. 

As a personal trainer, I know those benefits make a menopause HIIT workout worth your time, but there's another reason. According to a review published in Experimental Physiology, HIIT helps lower visceral fat (around your organs), which often builds up during menopause. 

With that in mind, I've put together an eight-move menopause HIIT workout that you can do anywhere, only takes 15 minutes, and will boost your mood, improve your cardio fitness, and build strength. 

Menopause HIIT workout routine

This routine is designed to be efficient but intense, so you'll do each exercise for 30 seconds, rest for 20 seconds, then start the next move. Do all eight moves twice to begin, gradually increasing to three sets as you get stronger. 

Make sure you spend 5-10 minutes doing a warm-up to prepare mentally and physically for exercise. Cooling down at the end with some low-intensity exercise is just as vital, as it helps reduce your heart rate, encourages relaxation, and can soften post-workout soreness. 

Menopause HIIT workout plan

1. Lunge hops

• Start standing with your feet together, then step back into a reverse lunge with the right leg. Your right knee should be parallel to the floor or as close as possible.
• Push through your heel as you bring your knee into a hop, jumping off the floor with your left leg as you come up.
• Swap legs and repeat for 30 seconds.

2. Broad jumps

• Stand with your feet shoulder-width apart, then bring your hips back and bend your knees to sit back into a half squat.
• Explode into the air, pushing off from your toes, and swing your arms forward and straight up above your head.
• Jump as high and as far forward as possible, then quickly shuffle back to the start position. 
• That's one repetition. Repeat for 30 seconds.

3. Curtsy lunges

• Stand with feet hip-width apart and shoulders back, and tense the muscles around your stomach to engage your core.
• Putting your weight into your right foot, step back with your left foot behind your right foot — almost as if you're curtsying.
• Bend your knees and lower your hips until your left thigh is almost parallel to the floor. 
• Push slowly back up and return to the initial standing position. 
• Repeat on the other side and alternate for 30 seconds. 

4. Squat jumps

• Stand with your feet shoulder-width apart and knees slightly bent.
• Bend your knees and press your hips back as if you're going to sit down on a chair.
• Push through your heels and squeeze your glutes (the muscles around your buttocks) as you jump out of the squat. 
• Land back in the starting position with your feet shoulder-width apart. 
• Repeat for 30 seconds. 

5. Mountain climbers

• Start in a plank position, with your hands shoulder-width apart, your back flat, and your shoulders above your wrists. 
• Tense the muscles around your stomach to engage your core, and pull your right knee diagonally towards your chest. 
• Return to the plank position with your right foot back on the floor. 
• Repeat on the other side and alternate quickly for 30 seconds. 

6. Ice skaters

• Stand tall with your arms by your side and legs slightly wider than shoulder distance apart. 
• Hinge at your hips and lean forward as you bring one leg behind you into a reverse lunge with your front knee at 90 degrees. 
• Swing your arms in front of your bent knee and leap your back leg forward to switch sides in a skating motion. 
• Alternate your arms as you switch sides like a speed skater.

7. Plank walkouts

• Start in a plank position, with your hands shoulder-width apart, your back flat, and your shoulders above your wrists. 
• Tense your stomach muscles to engage your core and create a straight line from your back down to your feet. 
• Your feet should be slightly wider than hip-distance apart. 
• Slowly walk your hands forward, maintain a straight back, and don't let your hips or tummy drop toward the floor. 
• Once you've walked out as far as possible without impacting your posture, pause, then walk your hands back to the start position. 
• That's one repetition. Repeat this pattern for 30 seconds. 

8. Up-down plank

• Start in a plank position, with your hands shoulder-width apart, your back flat, and your shoulders above your wrists. 
• Lower your right elbow to the mat, then your left, coming into a low plank hold. 
• Hold this position for a few seconds, then place your right hand on the mat and straighten your right elbow. 
• Do the same on your left side to return to a plank position. 
• Repeat this pattern for 30 seconds. 

This routine is designed to help keep your body moving and should help reduce the severity of menopause symptoms like tiredness, low mood, and weight gain. 

High-intensity routines are ideal for managing your weight, as the short rests keep your heart rate high, so you burn more energy than during a traditional steady-paced routine. 

And sustaining this elevated heart rate prompts longer-term changes to your metabolism, which is why many people also take on a HIIT workout for fat loss. But this menopause HIIT workout has other benefits. 

Exercising for happiness is a legitimate goal, and HIIT is a great way to get your body moving and encourage the release of mood-boosting hormones that can improve your wellbeing. 

The food we eat also plays a crucial role in how we feel, so it's worth putting together a menopause diet plan. Importantly, it doesn't need to be restrictive, so you can enjoy some of your favorite foods and support your body through menopause. 

People often think of high blood pressure (hypertension) as a condition that mainly affects men, but this isn’t entirely accurate. While men generally have higher blood pressure than women at similar ages, post-menopause, blood pressure rises more steeply in women. And according to the American Heart Association, females account for almost 52% of deaths resulting from high blood pressure. 

Some health practitioners put this down to hormonal changes, but various factors can affect blood pressure. While the best menopause supplements might help you combat certain symptoms, like low libido, they won’t help with serious hypertension problems. 

We spoke to a doctor, to unpack exactly how menopause affects this key component of your health. 

Does menopause affect your blood pressure?

Studies have found that during a woman’s reproductive life (from the first period to menopause), she is at a lower overall risk than a man of developing high blood pressure because of the protective effects of estrogen. Estrogen helps keep the blood vessels flexible, so blood can flow more easily. Since women of reproductive age generally have high estrogen levels, they enjoy a relatively broad level of protection from high blood pressure.

Dr Ferhat Uddin, a general practitioner, menopause expert, and the founder of Liberty Health Clinics, explains what happens during menopause, “It’s thought the fall in estrogen after menopause and the ratio/balance of estrogen to other hormones can increase blood pressure. One way this happens is that some women become more sensitive to salt. Menopause is also often associated with weight gain, resulting in insulin resistance and a rise in blood pressure. Generally, the fall in estrogen post-menopause can decrease the elasticity of our blood vessels, increasing the risk of cardiovascular disease.”

According to Blood Pressure UK, a person’s heart attack risk is five times higher after menopause than before. This is likely due to increased blood pressure.

The American Heart Association states that you have an increased risk of developing high blood pressure if you are 20 pounds or more overweight, have a family history of high blood pressure, or have reached menopause.

How can you manage your blood pressure?

Dr Uddin says, “Diet, especially reducing salt intake is important; as well as increasing exercise and managing weight. A small amount of weight loss can have a significant effect in bringing down blood pressure. Hormone replacement therapy (HRT), only if used transdermally (patch, gel, or spray), will have a positive effect on reducing blood pressure. HRT when started within 10 years of menopause will reduce cardiovascular risk in women.

There are many steps a person can take to manage their blood pressure and lower their risk of developing complications from high blood pressure. The Centres for Disease Control and Prevention (CDC) recommends:

• Taking regular blood pressure readings: High blood pressure typically does not cause any symptoms, so the only way to know if you have high blood pressure is to check it regularly. You can speak with your doctor about getting a blood pressure check or purchase your own blood pressure monitor and check it yourself at home. The latter option may be more convenient for people diagnosed with hypertension and those at increased risk of developing the condition.
• If you smoke, try to quit: Smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you stop.
• Exercise: Physical activity can help keep you at a healthy weight and lower your blood pressure. The Physical Activity Guidelines for Americans recommend that adults get at least two hours and 30 minutes of moderate-intensity exercise every week, such as brisk walking or cycling. 
• Eat a heart-healthy diet: To get the nutrients you need, the American Heart Association recommends eating a dietary pattern that emphasizes fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, and nuts, while limiting red meat and sugary foods and beverages.
• Limit your alcohol intake: Do not drink too much alcohol, which can raise your blood pressure. The CDC recommends men should have no more than two alcoholic drinks per day, and women should have no more than one alcoholic drink per day.
• Take medications according to the doctor’s instructions: People with high blood pressure must take all medications their doctor prescribes, even if they feel well. Hypertension typically does not cause any symptoms, so a person may feel completely well until a complication of high blood pressure occurs, such as a stroke.  

When should you see a doctor about menopause symptoms?

If you’re not sure that the symptoms you’re experiencing are related to menopause, talk to your doctor about them. They can give you information about menopause and help you cope with common symptoms. If your symptoms are severe or are disrupting your life, your doctor may recommend one or more treatments.

Dr Uddin says, “Symptoms that are troubling you should always be discussed with your doctor. Common symptoms often overlooked are anxiety, mood changes, brain fog, poor concentration and lack of energy and drive. HRT can alleviate these symptoms safely for many women.”

It’s important to remember that high blood pressure doesn’t usually have symptoms, so you may not know that you have it. However, the American Heart Association recommends that adults with normal blood pressure should get blood pressure checked each year at routine health visits. 

The best menopause supplements can help reduce your symptoms, making it easier to get on with your day. Whether you're experiencing night sweats, extreme fatigue, or mood swings, these capsules can help. 

But there are many options out there, so we've tested a range of menopause supplements to help you find one that is easy to swallow, doesn't taste awful, and you can make a regular part of your routine. 

Not everyone will experience the same menopause symptoms, so we've also included several supplements aimed at specific symptoms across a range of budgets and dietary requirements. 

However, we recommend talking to a doctor or medical professional before adding any of the best menopause supplements to your diet, especially if you're undergoing Hormone Replacement Therapy (HRT).

The best menopause supplements you can buy right now

From Vitabiotics’ popular range of affordable multivitamins, Menopace emphasizes some of the nutrients that matter most at this time of life. In fact, it contains a total of 22 nutrients, including vitamin D and magnesium, which are important for keeping bones healthy and strong as estrogen levels fall. It also contains vitamin B6 to help regulate hormonal activity, and B12 for energy release.

Where this product differs from a standard multivitamin is the additional dose of soy isoflavones. These are plant compounds that mimic the effect of estrogen by binding to estrogen receptors in the body, helping to manage symptoms such as hot flushes and night sweats.

But be careful supplementing with isoflavones if you’re taking blood-thinning medication, diabetic medication, or HRT, as it may lead to negative interactions. Menopace may also be unsuitable for anyone with an estrogen-sensitive issue such as endometriosis, so make sure you consult a doctor before taking them.

This also isn’t the supplement for you if you’re looking for the benefits of medicinal herbs, such as black cohosh. However, if you’re looking to support a range of different menopause symptoms, this all-round multivitamin provides a combination of the main nutrients you need in one pill.

Note, the capsule is on the larger side, but it's got a smooth coating that makes it relatively easy to swallow. The capsules are also packaged individually, in a similar way to OTC medication. This seemed a bit unusual, but actually we found it helped us keep track of whether we'd taken the multivitamin.

If you want a bit of insurance to top up your balanced diet at midlife, Menopace is a great choice. As it’s a multivitamin, though, be careful when taking it alongside other vitamins; more is not necessarily better when you’re dealing with concentrated doses of a nutrient.

Ayurveda is the traditional Indian medical system, working with native plants to bring balance back to the body. This supplement from trusted company Thorne is based on shatavari, an adaptogenic herb considered a tonic for the female reproductive system. 

Although it’s been in traditional use throughout the ages, like many medicinal herbs, shatavari hasn’t been studied extensively, though study published in the Journal of Herbal Medicine did suggest it may help ease hot flushes and night sweats. 

This nourishing supplement also contains sage, known to help with vasomotor symptoms, anti-inflammatory turmeric, and B vitamins, important for energy and mood. With all-organic ingredients, it’s suitable for vegans and has fans swearing it’s helped where other products haven’t. 

We love the sleek, minimalistic packaging with light purple accents. The capsules themselves are on the smaller side and have a smooth coating, so they are easy to swallow.

However, we found it disappointing that the capsules only take up half the container. This seemed a waste of packaging, as the unit could easily be half the size, especially as it is made from plastic, not glass.

The Now Menopause Support is based on a blend of herbal extracts thought to be beneficial during menopause. One of these is black cohosh, a perennial plant native to North America and traditionally used by Native Americans to help in female health conditions

Research published in the journal Menopause suggests that it may play a role in managing hot flushes, night sweats, and mood changes. It also contains red clover, licorice, ginger, and soy isoflavone — the latter are plant compounds that mimic the effects of estrogen.

Now Menopause Support is also non-GMO (not genetically modified), Kosher, gluten-free and vegan. Since this is a herbal blend, it’s safe to take it alongside a multivitamin.

However, as black cohosh may have hormone-like actions, this isn’t one to take if you’re on HRT or other hormonal treatments, or if you may be pregnant. While this is one of the most affordable menopause supplements on the market, 90 capsules will only last you a month, so it may be worth stocking up on a few containers.

The capsules themselves have a faint 'herbal' smell about them, but the coated outer layer masks any unusual taste and they are easy to swallow. 

Hair loss is one of the lesser-known symptoms of menopause, but one that can cause frustration and anxiety for many women. As menopause begins, estrogen and progesterone decline rapidly. 

Testosterone also declines, but at a much slower rate. This can result in ‘testosterone dominance’ and overall hair thinning, receding hairline, and unwanted facial hair growth.

Nutrafol’s Women’s Balance is designed for women before, during, and after menopause and claims to use medical-grade, natural ingredients that target the root causes of thinning, such as hormones, aging, and metabolism.

Potential benefits may include visibly thicker volume, less shedding, and hair that grows faster and longer. As well as targeting hair loss, it also claims to improve sleep and mitigate hot flashes.

According to the manufacturers, however, you can expect to see results within three to six months, so if you’re looking for immediate relief from menopausal symptoms, this probably isn’t the product for you.

One key benefit of Nutrafol, however, is that it’s safe to take alongside hormone replacement therapy, with the manufacturers reporting no known interactions with estrogen, progesterone, or testosterone replacement therapy.

The Nutrafol Women's Balance comes in a sleek, black glass jar and feels like a premium supplement. The capsules are on the larger side, but they are coated which we found makes them easier to swallow. 

Hot flushes are probably one of the most well-known menopause symptoms, and can range from an occasional sensation of a slight temperature increase, to leaving you dripping in sweat.

It’s not known exactly why hot flushes occur, but it’s thought that a drop in reproductive hormones can affect the hypothalamus – an area of the brain that acts as the body’s thermostat.

One of the best ways you can support hot flushes naturally is to consider phytoestrogens – these are plant compounds that can help to address hormone imbalances. 

These Pure Encapsulations Phytobalance capsules from the well-respected supplement brand, claim to naturally promote healthy estrogen-like activity and may reduce hot flashes.

Each capsule contains extracts of black cohosh, sage, licorice, motherwort, chaste tree, and grape, medicinal herbs that have been linked with a reduction in menopause symptoms.

How to choose the best menopause supplements for you

Price is an essential factor when choosing the best menopause supplements since you don't want to break the bank to manage your symptoms, but there's more to consider before you decide. 

Alternatively, the form a supplement takes might decide for you. Whether you prefer a capsule, a pill, or a powder supplement, we've considered many different options in our guide to help you choose. 

It's also worth considering whether the menopause supplement is vegan-friendly, as some use animal-derived sources of B12, which aren't appropriate if you follow a plant-based diet. 

You may also find that your body needs some extra support in other areas. As your body changes, so do your nutritional needs, which is why many people start taking the best vitamins for women over 50 to pick up where your diet leaves off. 

How we test the best menopause supplements

As the effects of a supplement will depend on your body's needs, we've tested the experience of taking the menopause capsules instead. We check the ingredients to see if they're well-known for menopause symptoms and whether they're vegan-friendly. 

We also take each supplement ourselves to see how easy the capsule or pill is to swallow and if it leaves an unpleasant aftertaste or repeats on us. Finally, we combine all of this to assess whether the supplement is good value for money. 

FAQs

October marks the start of World Menopause Awareness Month. While at Fit&Well, we share tips, advice, and information all year round, we’re putting the spotlight on the support available to those going through menopause.

The annual event, a collaboration between the International Menopause Society and the World Health Organization (WHO), helps raise awareness of this previously little-discussed part of a woman's life and the options you have for managing the symptoms.

These range from hot flushes and mood swings to changes in libido and memory loss, so it can be an extremely disorientating and overwhelming time, which is why we want to highlight how to reduce the symptoms and make this transition more comfortable. When these symptoms affect your everyday life, we want our readers to feel empowered to find the support and advice they deserve.

Cognition and mood are the theme of this year's Menopause Awareness Month, placing a focus on the mental changes and challenges that people face during menopause. This includes well-known symptoms like mood swings, as well as less talked about symptoms like brain fog.

October 18th, 2022 also marks the focal point of the awareness-raising month; World Menopause Day. We want to keep the conversation going, so throughout the month we'll be sharing everything you need to know about menopause and tips on how to get through it. 

World Menopause Awareness Month: advice and tips

• Ever wondered what happens during menopause?
• Read up on all the menopause symptoms
• Manage symptoms with the best menopause supplements
• Look out for these early menopause symptoms
• Find out why menopause makes you tired
• We look at whether bleeding after menopause is normal
• Top up your nutrition with this menopause diet plan
• Learn how to manage menopause brain fog
• Find relief from menopause itchy skin
• Try out some of the top menopause exercises
• We answer “Does menopause cause hair loss?”
• We investigate can menopause cause weight gain?
• Slow things down with yoga for menopause
• Take a different approach with these natural remedies for menopause

Does menopause make you tired, and how can you manage this? It’s a very important question many women will want to know, especially if you’ve heard it discussed as a symptom of menopause. Or perhaps you already suffer from feelings of fatigue, and are worried about this heightening when you eventually go through the change yourself.

Menopause occurs when your ovaries stop producing as much of the hormone estrogen and when they stop releasing an egg every month. Hormones play a vital role in regulating energy production, so any changes in your hormones can also affect your energy levels. This is why some women can feel as though they lack energy as they go through menopause. Some of the best menopause supplements are recommended for menopausal women to help regulate hormones and symptoms. In addition to this, learning more about menopause and its effect on energy levels and tiredness can help you better combat this.

Menopause and hormone health expert, Nicki Williams, shared with us some expert knowledge on why menopause makes you tired, what impact the transition can have on your sleep, how long the lower energy levels can last and perhaps most importantly, ways to overcome fatigue during the transition. Diet can impact many areas of our lives, including our hormone levels, so we asked nutritional therapist Rosie Millen to share some top tips on what foods can help to boost your energy levels while going through menopause. 

Why does menopause make you tired?

If you’re in the early stages of menopause (perimenopause), experiencing it now, or in the postmenopause era, it’s highly likely that the transition has affected your hormone levels. But if you're unsure if you're even experiencing menopause, we have a guide to all the menopause symptoms to help you out.

As your hormones change during menopause this upsets the usual rhythm and balance of your hormone activity. It’s not uncommon for your cortisol to be higher as a result of increased stress. Science has also found an association between stress and sleep during menopause. Research published in the Menopause journal concluded there is a relationship between stress and fatigue throughout menopause and that this will change throughout the different stages of the transition. Nicki Williams who has also written the book, It’s Not You, It’s Your Hormones – The Essential Guide for Women Over 40 to Fight Fat, Fatigue and Hormone Havoc, said that increased stress can impact your sleep and energy levels during the day. 

Williams says, “Progesterone is declining and that can affect your sleep. Thyroid hormones can also be lower than optimal at this time, making you feel more sluggish. And if we are eating sugary food or refined carbohydrates, we can end up on the blood sugar roller coaster, which can leave you feeling tired, foggy, and cranky.”

Another reason you may be experiencing intense feelings of fatigue during menopause could be down to nutrient deficiencies. This can easily happen as your body goes through a big change, but this should give you a greater imperative to fix this. Ensuring you are getting plenty of iron, B12, and vitamin D is essential and you can also take some of the best vitamins for women over 50 to take extra care of your body as you age. 

Does menopause affect your sleep and if so how?

According to Sleep Foundation, one in four women experience symptoms of insomnia, and the risk of insomnia increases with menopause. They state that 61% of postmenopausal females report having insomnia symptoms.

It’s pretty clear that menopause can disrupt sleep. Williams confirms this when we speak to her:

“Progesterone has a calming effect on the brain so it helps with sleep quality and anxiety symptoms. Sleep issues can also be due to high cortisol (stress), high insulin (back to that blood sugar balance!), dehydration, too much caffeine or alcohol, and low melatonin (your sleep hormone),” said Williams. 

Will menopausal tiredness last?

It will last but only until you find out exactly what’s causing it and are proactive about trying to amend this. Fatigue is a clear sign that something in your body is out of balance, whether you’re going through menopause or not. 

Williams advises you start looking at your hormones so that they can work optimally without draining you. Her key tips are to eat a nutrient-dense diet, drink plenty of water, rest and sleep sufficiently, move regularly, and limit toxins (such as synthetic chemicals and processed foods). These will all help to balance your hormones and get you on the right track for feeling more energized and perky again.

Research published in The Journal of the North American Menopause Society has also proven that moderate to high-intensity exercise is associated with increased energy levels for menopausal women. Physical activity might be the last thing you want to do if you’re feeling sluggish all the time but finding the right exercise is key - find out more about the best menopause exercises to help alleviate symptoms like fatigue.

Menopausal nutrition - what foods can combat tiredness?

If menopause is exhausting you, it’s important you turn to your diet since food plays a crucial role in energizing our bodies. Like Williams mentioned before, nutrients are essential. A woman’s bones begin to thin faster than usual when estrogen starts to decline during menopause. Therefore, you should aim to eat more calcium-rich foods which can be dark leafy greens like spinach and kale, also turnips, collard greens, and soya beans are good sources of calcium.

Registered nutritionist Rosie Millen tells Fit&Well that vitamin D is essential for absorbing and using calcium. “So, it makes sense that if you need more calcium, you also need more vitamin D. Low energy or fatigue is a common symptom of vitamin D deficiency. You can find sources of vitamin D in salmon, tuna, eggs, and fortified foods,” she adds.

Another top nutritional tip from Millen is to make sure you’re consuming plenty of protein-rich foods. You may be wondering, does protein give you energy? Technically this isn’t its main role (unlike carbohydrates, which our bodies process more easily for energy) but nutritional therapist Rosie Millen explains that protein will help to stabilize your blood sugar levels and manage your energy throughout the day. 

Eating foods like eggs, salmon, turkey, and quinoa with every meal can help to steer you away from highly processed sugary foods that can trigger blood sugar crashes and energy drops. If you don’t think you consume enough protein-rich foods day-to-day then you can always add one of the best protein powders for women to things like smoothies or even a pancake mixture.

You might also notice a positive change in energy levels when you limit your caffeine intake. This is a tough one for any coffee addicts, but there’s always decaf options available in grocery stores and coffee shops. Millen says that caffeine meddles with blood sugar and cortisol levels, so it's good to avoid coffee if you’re feeling fatigued. She warns that caffeine can increase some menopause symptoms, so stick to one cup a day where possible. 

Plus drinking coffee after 2 pm or six hours before bed can prevent the release of melatonin (this manages your natural sleep pattern) and cause you to feel restless when trying to get to sleep.

Is bleeding after menopause normal? Dealing with hormonal imbalances, weight gain and mood swings can be difficult, but it’s important that we pay attention to changes in ourselves - no matter how small they might seem. Understanding post-menopausal bleeding means becoming aware of our hormones and how they impact us. 

According to the UK’s NHS, post-menopausal bleeding is defined as ‘having bleeding at least 12 months after your periods have stopped’. Causes often vary, but the most common reason is fluctuating hormones, which peak and dip dramatically during the menopause. 

“Women typically over the age of 45 who have not had a period for over a year, are usually diagnosed to have entered the menopause,” says Shree Datta, a consultant obstetrician and gynaecologist at The Lister Hospital. “After this point, any vaginal bleeding requires investigation and testing by a gynecologist, as it is classed as abnormal bleeding. The cause is often treatable, but occasionally it can be symptomatic of a more serious condition, such as uterine or cervical cancer.” 

Want to find out if bleeding after menopause is normal? Here, our experts divulge the possible causes and treatment options. For support during and after the menopause, check out our guide to the best menopause supplements.

What causes post-menopausal bleeding?

“Fluctuating hormones can cause the thinning and inflammation of the lining of your vagina or uterus, which is commonly the cause of post-menopausal bleeding,” says Datta. “This is often due to lower levels of estrogen - a female sex hormone - being produced during menopause, but bleeding can also be caused by growths, otherwise known as polyps, in the cervix or uterus.” 

Polyps are not typically cancerous and are often estrogen-sensitive, meaning uterine polyps are often caused by changing estrogen levels within the body around the time of the menopause.

Symptoms that are often present with post-menopausal bleeding:

• Pain during or after sex
• Pain when urinating 
• Regular or persistent urinary tract infections
• Spotting 
• Itching or burning sensations around/or in the vaginal area

“A less common cause of post-menopausal bleeding is when some women develop a thickened endometrium - or womb lining - that can cause bleeding and eventually lead to womb cancer,” says Datta. “This may be caused by high levels of estrogen, being overweight, or sometimes as a side effect of hormone replacement therapy used to help women struggling with menopause symptoms. It can also lead to problems such as anemia, as your body doesn’t have enough red blood cells.” Other causes of post-menopausal bleeding can include cervical or uterine abnormalities, such as ovarian or womb cancer. 

Is bleeding after menopause normal?

Post-menopausal bleeding can be caused by a number of different factors, including vaginal dryness, hormonal fluctuations, or vaginal atrophy (the inflammation of the vaginal wall). The bleeding can be heavy or light. Regardless of what you suspect might be causing your post-menopausal bleeding, it’s important to speak to your doctor if you notice any bleeding after menopause.

“If you experience any bleeding from the vagina post-menopause, you should speak to your GP about what is causing it so they can do the necessary investigations,” says Dr. Samantha Wild, Women’s Health Lead at Bupa Health Clinics.  “It’s a common problem for women during this period, but it must be investigated to exclude anything serious, such as ovarian and womb cancer. Your doctor may want to refer you for further investigations to find out what is causing the vaginal bleeding; it could be just a result of your hormone levels changing or it could be something serious, so it is important that it is investigated properly.”

Treating bleeding after menopause

If you have been diagnosed with post-menopausal bleeding, your doctor will most likely refer you to a gynecologist - a specialist dealing with the health of the female reproductive system. “Treating abnormal bleeding depends on its cause, so a number of tests will be carried out,” says Datta. “This can include taking your history and asking questions about your health in general, for example, how you’re eating, sleeping, and whether you’ve noticed any weight loss or weight gain. A physical examination will then commence, as well as blood tests, and an ultrasound to investigate the lining of your wombs and ovaries.” 

The treatment you have will depend on the results of your tests and the cause of your bleeding. “Your gynecologist will discuss treatment options with you once they have determined the reason behind your bleeding,” adds Datta.

Treatment options for post-menopausal bleeding can include the following:

• The thinning of the vaginal skin due to the menopause can be treated with drugs that can come as a tablet, cream, skin patch or vaginal gel, that slowly releases medication into the body.
• Polyps are usually removed surgically in a procedure called a hysteroscopy. This may be done under local or general anesthetic depending on the size, number, and location of the polyps.
• A thickened endometrium can be treated with medication recommended by your gynecologist, such as progestin. In some cases, atypical endometrial hyperplasia can lead to an increased risk of cancer. If this is the case, then your healthcare provider may recommend a hysterectomy to remove the uterus.
• Gynecological cancer such as uterine or cervical cancer will usually be treated with a hysterectomy or total hysterectomy. This involves removing the uterus, fallopian tubes, and both ovaries in a hysterectomy, as well as the cervix and upper parts of the vagina in a total hysterectomy.
• Following medical treatment, lubricants to moisturize and dilators to widen the vagina can help to combat vaginal dryness and pain during sexual intercourse. These are sometimes used in conjunction with HRT. 

As post-menopausal bleeding is often caused by a hormonal imbalance, it can be difficult to prevent. However, maintaining a healthy weight, quitting smoking, and avoiding using vaginal douches or washes can help keep your hormones healthy. 

Our menopause diet plan has lots of tasty meal ideas to keep your blood sugars steady. Try these menopause exercises to make the transition easier too.

With symptoms such as hair loss, anxiety and brain fog, the menopause can often feel like a hormonal rollercoaster. This is where our menopause diet plan comes in, designed to help you nourish yourself and optimize your wellbeing during this transition. 

“Much like puberty, which is a huge transitional period in terms of hormones, the menopause also takes a toll on our body,” says registered nutritional therapist Jackie Lynch, author of The Happy Menopause. “This isn’t the time to be following a low-fat diet, because even though weight gain during the menopause can be an issue, the body uses fat to create sex hormones which often deplete during the menopause.” 

To keep your blood sugar levels stable, your energy up and your hormones balanced, our menopause diet plan will help you to tweak the different components of your breakfast, lunch, and dinner and understand how to structure your plate. If you’re looking for extra support on top of your diet, read our guide to the best menopause supplements.

What to eat during menopause

The optimal menopause diet plan consists of balancing the main food groups, including protein, fat, and carbohydrates. “The good news is that food that contains protein will probably contain fat as well,” says Lynch. “Menopausal women need adequate protein in their diet for a range of reasons, such as balancing our blood sugar - which needs to stay stable to avoid those sugar cravings that lead to weight gain. A dip in our blood sugar can also release the stress hormone cortisol into the body and this interferes with our production of sex hormones as our body will prioritize cortisol over estrogen.”

A 2020 study found that during the menopause, women lose around 40% muscle mass and 25% of bone density. This is why good quality sources of protein are integral for menopausal women.

“Most people know we need to eat protein for muscle mass and bone density, both of which become an issue around the menopause,” says Lynch. “We also need the amino acids from protein, as these influence our memory, mood, and our concentration. Eating protein with every meal and every snack means your body isn’t producing more stress hormones which disrupt your brain functioning.”

Another important food group to factor into your diet is carbohydrates. “It’s important to eat wholegrain carbohydrates and starchy foods over sugary foods and white carbs during the menopause,” explains Lynch. “As the body uses carbs as its main form of energy, if we’re not exercising or moving enough, then any excess will be stored as fat.” Our guide on how to lose weight in menopause has more tips for avoiding menopausal weight gain.

The best menopause diet plan will include carbs in manageable portions. “Brown bread, wholegrain rice, and pasta are good because your body burns through these types of carbohydrates slowly, meaning your blood sugar is less likely to spike and you’re more likely to have healthy digestion,” says Lynch. “This is important because constipation puts pressure on the pelvic floor muscle which can cause urinary incontinence, a condition that many menopausal and post-menopausal women struggle with.”

Following pelvic floor exercises for women can also help to strengthen the pelvic floor during menopause.

Menopause diet plan: breakfast ideas

Once you hit your 40s and 50s, it’s time to tweak your diet. This means factoring in more protein, thinking about balancing your blood sugar levels, and considering your levels of micronutrients, such as magnesium, vitamin D, and omega-3 fatty acids. Here, Lynch has a meal plan to help you get started.

“The trick with breakfast is making sure you get that protein in,” explains Lynch. “If you’re a toast person, then stick to wholemeal toast to stop those blood sugar spikes. Avoid marmite and honey, which don’t add much nutritional value, and stick to toppings such as unsweetened nut butter, egg, or cottage cheese. 

“If you’re a cereal person, then look at having a couple of tablespoons of chopped nuts and seeds instead of shop-bought muesli. My favorite ingredient to add to smoothies and muesli is flaxseed, as this has protein and fiber and it’s a great source of omega-3. Flaxseed also contains phytoestrogens, which are plant compounds that mimic the action of estrogen in the body. You should aim to add a couple of tbsps - around 20g – into your morning cereal or smoothie.”

Example breakfasts could be:

• Poached eggs on a slice of wholegrain bread.
• 2 tbsp of homemade muesli (with sunflower seeds, hazelnuts, and brazil nuts) with 150g of full-fat yogurt.
• Blueberry and spinach smoothie with 1-2 tbsp (20g) of flaxseed.
• Cottage cheese with a handful of fruit and a sprinkling of chopped nuts and/or seeds.

Once you hit your 40s and 50s, it’s time to tweak your diet. This means factoring in more protein, thinking about balancing your blood sugar levels, and considering your levels of micronutrients, such as magnesium, vitamin D, and omega-3 fatty acids. Here, Lynch has a meal plan to help you get started.

“The trick with breakfast is making sure you get that protein in,” explains Lynch. “If you’re a toast person, then stick to wholemeal toast to stop those blood sugar spikes. Avoid marmite and honey, which don’t add much nutritional value, and stick to toppings such as unsweetened nut butter, egg, or cottage cheese. 

“If you’re a cereal person, then look at having a couple of tablespoons of chopped nuts and seeds instead of shop-bought muesli. My favorite ingredient to add to smoothies and muesli is flaxseed, as this has protein and fiber and it’s a great source of omega-3. Flaxseed also contains phytoestrogens, which are plant compounds that mimic the action of estrogen in the body. You should aim to add a couple of tbsps - around 20g – into your morning cereal or smoothie.”

Example breakfasts could be:

Menopause diet plan: lunch ideas

We often decide on our lunchtime meal in a bit of a rush, in between answering emails or taking a break from our screens. However, getting the right formula for lunch can not only help us to avoid the dreaded 4pm energy slump, but it can also help us to power through until dinner. 

“Women will often have lots of green vegetables in salads, but forget about protein,” says Lynch. “If you are having a salad at lunch, aim for a fist-size portion of protein, such as a chicken breast, salmon steak, or quinoa. This will keep you full and your blood sugars stable into the afternoon. If you’re having soup, then make sure it’s chicken and vegetable or lentil. Soups such as tomato or carrot and coriander won’t supply you with enough protein.”

Example lunches could be:

• Green salad (spinach, cucumber and tomatoes) with chicken breast, feta cheese, and a sprinkling of pecans.
• Two slices of wholemeal bread with chunks of chicken, a tbsp of hummus, a handful of spinach, and chopped cucumber and tomato.
• Chicken and lentil soup with a wholemeal roll.
• Tuna mayo with a wholemeal pitta bread and chopped green salad (spinach, cucumber and tomatoes).

Menopause diet plan: dinner ideas

“For the evening meal, think about dividing the plate into four,” says Lynch. A quarter of our evening meal should be protein (think chicken, fish or tofu), and aim for a fist-size portion of this. 

“Then your portion of starchy carb - such as rice, pasta or bread - should be no bigger than the protein. The next quarter should consist of leafy green vegetables, such as spinach, rocket, kale, broccoli, or watercress, and then the final part of your plates should contain any extra micronutrients – tomatoes, cauliflower, mushrooms, etc.” 

Including leafy greens provides our bodies with magnesium, which is important for menopausal women as it boosts bone strength by assisting the absorption of calcium, and helps to regulate achy muscles.

Some example dinners could be:

• Salmon steak, new potatoes, spinach, and green beans.
• Chicken breast with avocado, rocket, tomato, watercress, and quinoa salad.
• Tofu curry with brown rice and broccoli. 
• Lentil bolognese with wholegrain pasta and a portion of steamed spinach.

From hair loss to weight gain, menopausal symptoms vary depending on the individual, but a less well-known feature of this transitional period is menopause brain fog. 

According to a study published in the Journal of Women's Health & Gender-Based Medicine, around two-thirds of menopausal and peri-menopausal women claimed that their brain functioning has been impacted by the menopause. In fact, participants of the study cited menopause brain fog as the reason they had trouble concentrating, remembering events, and recalling words or numbers. 

Experts believe that our fluctuating hormones are responsible for menopause brain fog, but without understanding the cause and how we can treat it, our memory lapses can become frustrating to deal with. However, it is possible to implement strategies to help you overcome those foggy feelings. Below, our experts share the reasons why menopause brain fog strikes, what causes it, and how you can relieve its symptoms with the help of the best menopause supplements, tailored nutrition, and brain exercises.

What is the link between menopause and brain fog?

“‘Brain fog’ is not a medical or scientific term, but it is used by individuals to describe how they feel when their thinking is fuzzy,” explains Dr. Samantha Wild, Women’s Health Lead at Bupa Health Clinics. “As fluctuating estrogen levels impact the brain, brain fog is a very common symptom in perimenopausal and menopausal women.”

Typical symptoms of menopause brain fog include:

• Forgetfulness 
• Losing your train of thought midway through a conversation 
• Difficulty recollecting events or names

Our hormones are created by endocrine glands (the eight glands scattered around our body), but estrogen (a female sex hormone) impacts the production of glucose, which is vital for brain activity. Falling levels of estrogen cause a decline in glucose levels, which account for the fuzzy-like feelings many women experience during this time. Estrogen isn’t the only hormone responsible for disrupting our cognitive functioning. Progesterone, another female sex hormone, also drops during the menopause, causing a range of imbalances in the body. 

“During the perimenopause and menopause, the level of progesterone drops first, which can lead to irritability, sleep disturbance, mood swings, and brain fog,” says Shree Datta, a consultant obstetrician and gynecologist at The Lister Hospital. “Sleep disturbance can create a vicious cycle, often worsening the effects of brain fog, along with mood changes, lack of energy, low sex drives, and hot flushes.”

When does menopausal brain fog end?

There is no exact timeline for menopausal brain fog. Experiences vary wildly from person to person. “Some symptoms may only last for a few months and others can continue for several years,” warns Wild.  For one in 10 women, menopause symptoms can carry on for up to 12 years – but there is a silver lining. “It’s likely that the first year of menopausal brain fog will be the worst,” says Datta. “But from then on, it can become less severe. Brain functioning should return to more ‘normal’ levels after the menopause process is complete, but if you are struggling with symptoms I would advise speaking to your doctor.”

How can you treat menopause brain fog?

Over the years, all symptoms of the menopause should reduce – but in the meantime, there are ways you can manage symptoms of menopause brain fog. Here are just a few examples:

Eat the right foods

What we eat can play a huge role in how our body handles menopausal symptoms. To keep menopause brain fog at bay, make sure your diet is full of fresh fruit and vegetables to get the right vitamins, such as magnesium, calcium, and vitamin C into your body. 

“Slow-releasing energy foods, such as wholegrain pasta, oats, and nuts can keep you energized throughout the day,” says Wild. “Undereating can contribute to brain fog and make you feel easily irritated. If you’re looking to improve your diet, start by planning your meals and snacks for the week ahead, so you’re less likely to be drawn to sugary foods to keep your energy levels up. Sugary foods can cause our blood sugar to crash, which makes menopause symptoms like brain fog much worse.”

Take five

If you’re struggling with menopausal brain fog, then you need to allow your brain space to deal with it. “Factor in regular time away from your screen; whether you’re working in the office or at home,” says Wild. “Even if you simply look out the window and change your focus, it will give your brain a rest from constantly focusing.” 

Use your time away from your digital devices to work on puzzles such as crosswords and sudoku – these are aimed at training and stimulating the brain and a 2019 study showed that they contribute to better cognitive functioning. 

Get a good night's sleep

Don’t underestimate the importance of a good night’s sleep in helping to reduce symptoms of menopause brain fog. A tired mind can have a huge impact on our cognitive abilities. “A relaxing activity, such as a hot bath or reading your favorite book, can leave you feeling relaxed and ready to drift off,” says Wild. “Switch off your digital devices at least an hour before bed too, as the blue light can impact your circadian rhythm - your internal body clock - keeping you awake for longer.” 

If racing thoughts are keeping you up, try writing down what is on your mind. Not only can this help you to organize your thoughts and leave you feeling calmer, but it can stop any worries or stresses building up inside your head.

Seek support

There are lots of things you can do to help reduce the impact of menopause brain fog, but it’s also wise to seek help if you’re struggling to manage it. “If you’re struggling with brain fog, speak to your GP who may be able to recommend treatment for perimenopause or menopause symptoms,” says Wild. Estrogen replacement therapy can be a good option for women who are struggling with menopausal symptoms and can be used in many different forms, including pills, patches, or injections. 

Can you take supplements for menopause brain fog?

“There are many herbs and supplements aimed at women experiencing menopause symptoms and some of these can also reduce brain fog,” says Datta. A 2019 study found that low vitamin D levels can impact cognitive functioning in women of menopausal age, while a 2015 study found that omega-3 fatty acids can improve symptoms of brain fog, such as difficulties with attention and memory, when taken as a supplement. Check out our guide to the best fish oil supplements if you’re looking to top up your levels. 

What happens during menopause? Most of us have heard of it, but not many know what it actually means. It’s a huge part of many women’s lives, with symptoms varying significantly from person to person, including hot flushes, mood swings and vaginal atrophy.

The menopause is one of the biggest hormonal changes people with ovaries will go through and it poses significant changes to the body. The menopause typically happens in your mid-life, although the age that you start to experience menopause symptoms varies with each person, like with starting your period.

Even though a huge part of the population will experience the menopause, research from the State of Menopause Survey, conducted with 1,039 women aged 40-65 across the United States, showed that nearly one third (29%) of women never sought information about menopause before they experienced it. But being informed about your body is one of the best ways to help you deal with any health issues you might experience in your life.

If this all sounds a little overwhelming, don’t worry – we asked an expert to break down exactly what happens during menopause, so you can understand what you’re experiencing right now, or what you might experience in the future.

What happens during menopause?

In short, the menopause is when the menstrual cycle ends and your ovaries stop producing hormones. 

“Menstrual periods stop due to the change in the balance of the body’s sex hormones when the ovaries stop releasing estrogen,” explains Dr Sarah Welsh, gynaecologist and founder of the sexual wellness brand HANX. This means the ovaries no longer release an egg each month as part of the menstrual cycle, and you’re no longer reproductively fertile.”

According to the NHS, menopause usually occurs between 45 and 55 years of age, as a woman's estrogen levels decline. In the US and the UK, the average age for a woman to reach the menopause is 51. 

Welsh explains that although it is fairly rare, some people do undergo an early menopause, which can happen as early as in your 20s or 30s. However research from the Cleveland Clinic found that premature menopause only happens to 1% of women under 40.

There are three main stages of menopause: perimenopause, menopause and post-menopause. Each one sees the body go through different hormonal changes, resulting in varied symptoms. 

The stages of menopause

The perimenopause is the first stage of the menopause and it is thought to be a transitional period before a woman is officially ‘in menopause’. The perimenopause can last up to 10 years, although it can also be as short as four years. 

“This is when the ovaries gradually reduce the amount of estrogen hormone they release,” Welsh explains. “It tends to happen in your forties, and you can experience irregular periods and menopausal symptoms. However, it’s important to be aware that you can still get pregnant during this transitional period.”

Menopause officially begins when your periods have stopped for 12 months, meaning the ovaries have stopped releasing estrogen completely. 

Finally, the post-menopause is the stage you reach when you haven’t had a period for 12 months and you experience some relief from menopausal symptoms. 

“During this stage, you can no longer get pregnant naturally, and due to low estrogen levels, you are at a higher risk of health problems such as osteoporosis and heart disease,” Welsh says.

What are the symptoms of menopause?

Menopause symptoms vary from person to person but, according to Welsh, common symptoms include hot flushes, night sweats, vaginal dryness, urinary urgency (needing to pee often), memory changes, menopause anxiety and changes in libido. Some people also experience insomnia, itchy skin and hair loss or thinning.

“During the perimenopause, you may find your PMS is worse than normal, your periods may change in terms of flow and frequency, or you might experience tender breasts,” Welsh adds.

The menopause is a retrospective diagnosis, meaning you can only certainly diagnose it once it has happened – i.e. you haven’t had a period for 12 months in a row. According to the charity Menopause Support, approximately 38% of women seek help from a GP to deal with menopause symptoms, which can last up to 15 years.

There are also some symptoms that are less common. “Some people experience bloating, or weight gain due to the menopause, as well as other digestive problems such as constipation,” says Welsh. “Headaches or migraines can be a symptom, and others include dizziness, voice changes, and joint and muscle aches and pains.”

She adds that some people find their heart is racing and experience palpitations, while others may even notice tingling sensation in their bodies, breast sensitivity and itching or rashes to the skin.

As well as physical side-effects, the menopause can have a significant impact on mental health. A 2015 study found that 38% of women in late perimenopause experienced symptoms of depression, with people who have a history of mental health issues being most at risk.

Menopause symptoms are hugely variable and wide-ranging, and the change in hormones can affect nearly any part of the body. With this in mind, it’s best to consult a health professional if you have any concerns about your health that you think might be related to the menopause.

Menopause itchy skin can be a real problem during this transitional phase in a woman’s life. While we might typically think of mood swings, hot flushes and night sweats when it comes to menopause symptoms, skin changes such as pigmentation, rashes and acne can be just as common.

The name for this itchy skin is pruritus. Pruritus can start as early as perimenopause, which begins around eight to 10 years before a woman is officially ‘in menopause’, and lasts into the post-menopausal period. It may not sound too serious, but itchy skin can cause a lot of interference and discomfort. Hormonal changes linked to a lack of estrogen during menopause can cause itchy skin anywhere on the body too.

We spoke to Dr. Sharon Malone about menopause itchy skin, when it’s best to see a doctor, and some simple ways of soothing dry and irritated skin yourself. Our guide to the best menopause supplements may also be useful if you are looking for additional ways to support yourself during this time.

What’s the link between menopause and itchy skin?

Dry, itchy skin can be common for a number of reasons, and often they’re hard to nail down. But these symptoms can also be a complaint for women experiencing menopause, and may even manifest in and around the vulva in the form of vaginal atrophy.

This dry skin during menopause can occur anywhere on the body, but most commonly across the face, limbs, back, neck, and chest. Malone explains that the reason this happens is that during and after menopause, due to a decline in estrogen, the collagen, elasticity, and blood flow to the skin all decrease. Estrogen also keeps the production of natural oils in the skin moisturized, so without a strong level of this, the skin can feel dry and itchy.

It is thought that women's skin loses about 30% of its collagen during the first five years of menopause, and continues to decrease in a gradual way following those years.

The thinning of the skin brings the nerve endings closer to the surface which results in more irritation and heightened sensitivity to even normal stimulation. The newly thinned skin is also more susceptible to trauma and tissue damage leading to a worsening itch-scratch cycle – the more you scratch, the more you itch. The histamine released when you scratch makes the itching worse, and this can cause a nasty cyclical effect.

Itchy skin can occur anywhere but it is worse in areas that have more nerve endings, such as the vulva and nipples, explains Malone. In addition to itching, some women experience pain and burning in these areas during menopause, which can be very distressing.

When to see a doctor about menopausal itchy skin

When there is pain and itching in and around the vulva, most women can misinterpret these symptoms as yeast or vaginal infections, leading to self-medication without relief. When the symptoms are bothersome and not responsive to mild hydrating lotions, Malone says that it is time to consult a doctor. 

If the itchy skin does not involve the genital area, then a dermatologist can be consulted. If it is confined to the genital area, then a gynecologist would be more appropriate.

How can you treat menopause itchy skin?

There are lots of ways that you can prevent dry and itchy skin from becoming a problem during menopause:

• Quit smoking – smoking ages and damages skin 
• Use sunscreen – this prevents skin damage and aging
• Use unperfumed personal hygiene items
• Lower the temperature of your shower – hot water dries the skin
• Use unscented hydrating lotions immediately after a bath 

If you’re experiencing dry and itchy skin around the vulva, it’s important to remember:

• Don’t use scented sanitary products
• Minimize skin trauma by using vaginal lubricants during sex
• Topical estrogen can treat the root cause of vulva itching – consult a doctor if you’re considering estrogen replacement therapy 

If menopausal itchy skin is already a problem, then there are plenty of home remedies you can try out. These include:

Moisturizing

It's very important to keep the skin supple and moisturized with unperfumed and natural moisturizers. A good moisturizer will help the skin to absorb water, especially in its top layers, which can be great to help soothe itching.

Oatmeal baths

Oats can be used to treat a variety of skin conditions. The chemicals in oats known as avenanthramides have been found to help reduce itching and inflammation.

Colloidal oatmeal is made by grinding oat grain into a fine powder and is considered to be an emollient – a substance that soothes the skin – because of its high levels of fat, proteins, minerals, and vitamins. The Food and Drug Administration (FDA) has officially categorized colloidal oatmeal as a skin protectant and sees the anti-inflammatory and antioxidant properties as beneficial for itchy skin.

Adding this oatmeal to a warm bath and soaking in it for 10 minutes or more may help to soothe your itchy skin symptoms.

Vitamin C

Vitamin C is essential for skin health because it helps to promote collagen in the skin. A higher intake of vitamin C can help to boost moisture and repair, preventing it from feeling thin and dry. You can top up your levels of vitamin C by eating foods such as peppers, tomatoes, and citrus fruit. Alternatively, you could take a vitamin C supplement. 

Can you take HRT for menopausal itchy skin?

“Although itchy skin is not the sole reason for taking hormone replacement therapy in menopause, people who do take estrogen after menopause do tend to have fewer symptoms,” says Malone. 

Topical estrogen (used directly on the vulva) is very effective for treating vaginal atrophy and itchy, dry vulvas. Estrogen therapy has also been shown to modulate or reverse some of the skin changes related to aging, including epidermal and dermal thickness, collagen and elastin content, skin moisture, and wrinkles.

Speak to your doctor if you are considering HRT as an option.

Want to find out more about menopause? Check out our expert tips for yoga for menopause or find out; does menopause cause hair loss?

Menopause can be a daunting time, but there are lots of natural remedies for menopause to support you through this transition. From medicinal herbs to simple lifestyle changes, natural remedies can help to reduce your symptoms and get you back to feeling yourself again.

These remedies are especially useful if you prefer not to go down the hormone replacement therapy route - although many of the lifestyles tips we’ve rounded up below will also work alongside medication anyway. 

For extra support to see you through this time of life, you can also check out our guide to the best menopause supplements, where you’ll find products to suit a variety of budgets, lifestyles, and symptoms. For now though, here are 9 natural remedies for menopause.

9 natural remedies for menopause

1. Balancing blood sugars

As your hormonal makeup changes, you may find that your body changes too. A drop in estrogen levels can lead to a redistribution of fat in our bodies, as well as weight fluctuations or changes in your shape. 

You can avoid too much of an uptick on the scales by following a menopause diet. This helps to keep your blood sugar levels steady and avoids the peaks and troughs that can lead to overeating and weight gain. 

GP Dr. Marion Sloan explains how different foods can impact our blood sugar levels. “If you eat a chocolate bar that’s 250 calories, the blood sugar shoots up, followed by a surge of insulin which makes it crash down,” she says. “You get a slump in energy, a surge of appetite stimulated by the insulin rise, and you feel very hungry soon afterward. The same 250 calories as porridge are slowly absorbed over one-two hours. The sugar rises slowly, plateaus, and falls gently. So, you feel fuller for longer.”

Keeping your blood sugar levels consistent may also help to manage mood swings associated with menopause.

2. Phytoestrogens

One of the most well-researched natural remedies for menopause is the incorporation of phytoestrogens into your diet to support your changing estrogen levels. 

Nutritionist Dr. Naomi Newman-Beinart explains that phytoestrogens are naturally occurring plant compounds that can mimic the effects of estrogen in the body. “They have been found to be beneficial in combating symptoms and conditions caused by estrogen deficiency,” she says. “This may be of particular benefit to pre-, peri- and post-menopausal women. Studies have suggested that including plant-based foods rich in phytoestrogens may help women raise estrogen levels in their bodies. It is the depletion of these hormones that leads to all the troublesome effects associated with menopause.” 

Fiber-rich foods such as berries, seeds (particularly flaxseed), grains, beans, and nuts are all excellent sources of phytoestrogens.

3. Maintaining a healthy weight

When it comes to health, this advice isn’t new, but maintaining a healthy weight becomes particularly important after menopause when the risk of developing health conditions like heart disease increases. This is because estrogen keeps our cholesterol levels down throughout our reproductive lives, so once the estrogen levels drop off after menopause, we no longer benefit from its great cardioprotective properties. This makes it all the more important to ensure you’re eating lots of high-fiber fruits and vegetables to keep you feeling full and to discourage you from overeating. Try to limit your intake of processed foods too, as these are high in sugar, saturated fat, and salt and can lead to weight gain.

Carrying additional weight can also exacerbate your menopause symptoms, such as sweating and hot flashes.

4. Staying hydrated

While staying hydrated is important for everybody, it becomes particularly vital when going through menopause. Symptoms such as hot flushes and night sweats can be very dehydrating, so it is important to replace water lost during these episodes. 

If you’re struggling to take on enough fluids, check out our six easy ways to drink more water, or invest in one of the best water bottles to carry around with you.

5. Black cohosh

Black cohosh is one herbal remedy that may help to control the symptoms of menopause. You will generally find it in the form of a supplement made from roots of the black cohosh plant, which one study found was able to help reduce night sweats, hot flushes, and other menopause-related symptoms.

Newman-Beinart also suggests supplementing with black cohosh, among other natural remedies. “Various kinds of phytoestrogens are also found in many medicinal herbs, including red clover, black cohosh, alfalfa, hops, licorice, and turmeric – so look for these supplements too,” she says. 

It’s worth noting that medicinal herbs like black cohosh are not suitable for those taking HRT because they can have negative interactions. Speak to your doctor before supplementing.

6. Angus castus

Agnus castus or ‘chaste tree’ is a Mediterranean plant that contains phytoestrogens. These can have a hormone-balancing effect. One study found that agnus castus had a significant impact on symptoms of menopause, including disturbed sleep, night sweats, anxiety, and low mood.

7. Sage

One 2011 study into the efficacy of sage in controlling symptoms of menopause suggested that it has real clinical value for menopausal women, particularly in reducing hot flushes and night sweats. Sage’s ability to decrease the frequency and duration of sweating episodes may also help to reduce the disruptive impact of these symptoms on day-to-day life and improve hydration by lowering water loss. 

8. Red clover

Red clover contains phytoestrogenic compounds known as isoflavones, which makes it an excellent natural remedy for menopause. One study found it to be particularly useful in helping with hot flushes, which plague many women going through menopause. Red clover is often an ingredient in menopause supplements.

9. St John's wort

St John’s wort is widely used as a holistic remedy for depression and anxiety - symptoms that can be exacerbated or even brought on by menopause. Taking St John’s wort might help with menopause and anxiety, as a third of women report struggling with anxiety through this time. Whilst the exact cause of menopause anxiety is not known, it’s thought it may be due to hormonal imbalances impacting mood, as well as anxiety over physical symptoms.

For more on menopause, take a look at our features covering; does menopause cause hair loss? Or, try out yoga for menopause. 

Early menopause symptoms aren’t always easy to spot. Each experience of menopause is individual and no two women will follow exactly the same journey.  What we do know though, is that the earlier we can identify symptoms, the easier they tend to be to manage.  

There is much we can do to help lessen the impact of early menopause symptoms. With that in mind, we spoke to menopause experts about hormone replacement therapy (HRT) and some of the best diet, exercise, and lifestyle approaches, including supplements. You may also want to take a look at our guide covering the very best menopause supplements.

When does menopause begin?

Menopause is when a woman stops having periods. For most, this is classed as the time that follows 12 months without a menstrual period. “The ovaries have stopped functioning and the reproductive hormones progesterone and oestrogen are very low but stable,” explains gynecologist and health care advisor Dr Michelle Griffin. “The age women reach menopause varies but the average is 51.”

The phase leading up to menopause is called perimenopause.  “During perimenopause, the ovaries are functioning erratically and reproductive hormones are fluctuating,” says Dr Griffin. “It is this fluctuation of hormones which can cause symptoms such as hot flushes and irregular periods. This phase lasts, on average, around five to eight years and typically begins in the early 40s.” 

However, women experience menopause and perimenopause differently. Some may start to notice symptoms as early as their mid to late 30s, while for others it will be much later. “A well-regarded SWAN study showed that black, Latina, and Asian women tend to enter perimenopause earlier and have a longer phase of perimenopause with more intense symptoms,” says Dr Griffin.

What are the most common early menopause symptoms?

Early menopause symptoms can be vague, varied, and easily attributed to other things, such as stress or aging.  “It makes it hard for doctors to diagnose,” says Dr Griffin, who recommends completing a symptom checklist such as the one from Dr Louise Newson’s website Balance. “You could also track your symptoms for a month or two. The more preparation you do the better.  If you are 40+ and experience any of the relevant symptoms it's always worth asking the question, ‘Could it be the perimenopause?’.”

What else can you look out for?

Irregular periods

Fluctuating hormones can lead to irregular, heavy periods but this might not be your first symptom. “You can have regular periods and still be perimenopausal,” says Dr Annice Mukherjee, an endocrinologist and author of The Complete Guide to the Menopause.  “Heavy, unpredictable periods can be exhausting. The Mirena coil can not only stop the bleeding but can often lessen the severity of some of the other menopause symptoms too.”

Sleep

“Some women may have trouble getting to sleep while others may fall asleep easily but wake in the night,” explains Dr Griffin. “Supplements such as magnesium may help especially if you find it difficult to get to sleep. Cognitive Behavioral Therapy (CBT) is also great for improving sleep.”

Mood

Fluctuating hormones can also cause anxiety, low mood, irritability, and mood swings. “Some women describe it as a bit like elongated PMT throughout their cycle - it is more intense and frequent and lasts longer,” explains Dr Griffin. 

Dr Mukherjee recommends incorporating everyday mindfulness into your daily life. “Even something as simple as walking outside for 10 minutes and noticing the cold on your cheeks or the sound of the birds,” she says. “CBT and exercise can also be helpful.”

Aching joints

“Estrogen plays an anti-inflammatory role,” explains Dr Griffin. “Aching joints are common. You might also notice that you are more susceptible to injury or find it harder to recover from a workout.” 

“Regular physical activity and movement are almost always helpful for aching joints,” says Dr Mukherjee. “Physiotherapy and anti-inflammatory medication may also help and can be accessed through your doctor.”

Digestion

Some women suffer from digestive issues such as bloating and IBS during menopause and perimenopause. “With less calming, anti-inflammatory estrogen, and consequent effects on your gut bacteria (or gut microbiome), you might find your gut plays up more,” says Dr Griffin. “Taking regular exercise and eating more foods rich in prebiotics and probiotics can be helpful.”

Memory loss and brain fog

You may find you go upstairs and forget why, find it harder to reach decisions, or just feel a bit spaced out. It’s possible you are experiencing cognitive symptoms of perimenopause. 

A 2021 study found physical changes to the female brain during perimenopause. “The brain is affected by the fluctuations in oestrogen,” explains Dr Griffin. “Thankfully those dips in brain activity do come back up post-menopause. The brain adapts to the loss of oestrogen but it takes time.” 

A focus on diet may help. “Blood sugar dips can lead to a loss of focus so manage them by including slow-release carbohydrates in meals and reducing sugary foods,” says Dr Mukherjee. “Ensuring your diet contains optimal amounts of B vitamins and zinc can also help.”

Hot flushes

The most notorious of early menopause symptoms, hot flushes can occur at night or during the day without warning.  Caused by fluctuations in hormone levels they can be difficult to manage. 

“Caffeine may worsen hot flushes and night sweats,” says Dr Griffin. “While Cognitive Behavioral Therapy can sometimes help improve them.”

Breast tenderness

“Perimenopausal estrogen surges can lead to sore, tender breasts,” explains Dr Mukherjee. “Evening Primrose Oil or Starflower Oil supplements may help but it’s always worth getting breast soreness checked by your doctor.” 

How to cope with early menopause symptoms

“It’s common for women to try to manage early symptoms,” explains Dr Griffin.  “They hold out until it gets really bad but symptoms are easier to treat the earlier you catch them.  The desire to cover up symptoms can mean you have a horrendous time in your 40s. In extreme cases it can lead to the breakdown of relationships, losing work, and strained relationships with children.”

So, what things can help?

HRT and medication

“Hormone Replacement Therapy (HRT) is clinically proven to improve perimenopausal and menopausal symptoms and have preventative benefits on bone, heart, and brain health,” says Dr Griffin. “Research suggests that HRT has the most benefit and least risk when taken before the age of 60 or within 10 years of menopause. Although many women are nervous about the safety of HRT, the benefits outweigh the risks for many women.”

Not all women can (or want to) take HRT, however, and there are plenty of other options, including medication. “HRT isn’t a magic fix and a healthy lifestyle will significantly improve symptoms and long-term health either alongside HRT/medication or as a standalone treatment,” says Dr Griffin. 

Diet and exercise

“A healthy, balanced diet, increased physical activity and strength training will all help improve physique, prevent osteoporosis, improve mood regulation and sleep,” says Dr Griffin. “These three measures work together to better manage blood sugar which is critical for short and long term health.”

Supplements

“Menopause supplements are generally not supported by strong research evidence. However, some women do find different supplements helpful,” explains Dr Mukherjee. “It’s important to first check with your GP that there are no contraindications with any other medications you are taking. I would then suggest trying it for a few weeks to see if it helps. If it hasn’t helped after six to eight weeks then it probably won't. Also, if you feel great at first and then symptoms return, it may just have been a placebo effect.” For more on this, head to the best menopause supplements.

For more on menopause, take a look at our feature on menopause itchy skin: tips for relief. Plus, we answer; does menopause make you tired?

Wondering; does menopause cause weight gain? We asked the experts. As women enter perimenopause their bodies are undergoing significant changes. From shifting hormone levels to decreasing muscle and bone mass and falling metabolism. This is why we’ve found out exactly what impact these changes have on our bodies and our weight as well the impact of hormone replacement therapy (HRT), diet, exercise, and stress. 

Does menopause cause weight gain? Maybe, but not necessarily - and the good news is that there are lots we can do to avoid it. This is not the time for fad diets and extreme exercise plans but for nourishing the body and taking care of ourselves.  Stress reduction, strength training, and sensible diet advice can all play a part in helping us look after ourselves and our weight. Managing unhelpful menopause symptoms can also help and our guide to the best menopause supplements may also be useful here.

Does menopause cause weight gain?

“It’s not as straightforward as saying menopause ‘causes’ weight gain,” explains  Dr Annice Mukherjee, an endocrinologist and author of The Complete Guide to the Menopause. “As oestrogen and testosterone levels fall, our metabolic rate drops too. This means it is easier to gain weight. However, weight gain is multifactorial and HRT won’t necessarily prevent it.” 

Dr Mukherjee explains that both men and women also tend to lose muscle and bone mass from their 40s and, since muscle helps burn calories, that can also contribute to weight gain. On top of that, perimenopause and menopause are often stressful times of life. “We know that chronic stress can lead to weight gain,” she says.

How does menopause affect the body?

In addition to falling hormones and metabolism, there are other menopause symptoms that can contribute to weight gain. 

Perimenopausal hormone fluctuations can disrupt sleep, for example, which is thought to impact weight.  A lack of sleep has been found to lead to junk food cravings according to a 2013 study and observational studies have linked sleep deprivation with obesity.  Menopausal fatigue (which may be caused in part by disrupted sleep) is also likely to play a part. 

Joint aches and pains are other menopausal symptoms that can have an impact. “When our joints are aching we think we need to rest but in menopause, it’s essential that we move,” says Kate Rowe-Ham, a personal trainer, menopause coach, and founder of new platform Owning Your Menopause.  

“Menopausal weight gain tends to creep up,” says Rowe-Ham. It also tends to be stored around the middle as visceral fat which is implicated in health issues such as Type 2 diabetes and heart disease.”

How to cope with body changes during menopause

If menopausal weight gain is something you are concerned about, then understanding what is happening to your hormones and body can help you tackle it. “You have more power over it than you might think,” says Dr Mukherjee.

Hormone replacement therapy

“HRT  might help,” says Dr Mukherjee. “It might improve your sleep quality, energy levels, and aches and pains. It might also motivate you to implement weight loss strategies. Don’t expect it to be a miracle cure though because it’s not as simple as that. You need a whole lifestyle change and a mindset change towards food.”

The role of cortisol

“We become more susceptible to stress once we enter perimenopause as our stress response is supported by oestrogen,” explains Kate. “When we have high levels of the stress hormone cortisol in our body, we tend to store more fat.”

This means that the temptation to over-exercise and undereat could actually be counterproductive in the long run. “It can raise the level of stress hormones in the body which can inhibit the body from burning fat,” says Kate. “Following a sustainable diet and exercise plan with sufficient rest days is key.”

Movement can help 

“Regular physical activity will increase calorie burn as well as lowering and balancing the stress hormone cortisol. It will also help with menopause symptoms such as disrupted sleep and joint aches,” says Dr Mukherjee.

If you need to, start small.  “Most people spend at least 5-10 minutes on social media,” says Dr Mukherjee. “ Go outside for a walk in the fresh air instead.  Then you can build on that. Daylight is really powerful. It impacts the pineal gland which controls our body clock hormone melatonin and so helps with sleep, while the movement will also help reduce stress and improve mood.” 

Try strength training

“People sometimes believe if they just run and run they will burn more calories and lose more weight but strength training can be a more effective tool from perimenopause,” says Kate. 

“By increasing muscle mass, you will raise your metabolism and increase calorie burn as well as helping protect your bones. I would aim to build up to two to three 30-minute strength-training sessions a week, which can be as simple as bodyweight exercises such as squats and planks or resistance band exercises.” 

Don’t forget about rest days though. “If your muscles don’t have time to repair in between you won’t see the same muscle gains,” she says. 

“I actually find weight lifting addictive”, she says. “When I’m lifting weights all I’m thinking about is my form and what I’m doing. I can’t think about the dishes or anything else. It’s a bit of self-care.” 

Diet

Fad diets are not your friend in perimenopause and menopause. “If you are losing more than 1lb a week in weight, you are likely putting your body into starvation mode,” says Dr Mukherjee. “It will be on high alert with stress hormones which means you are likely to regain the weight more quickly as soon as you put the breaks on that diet. It is better to gradually restrict calorie intake by focussing on eating unprocessed foods which are lower in salt, sugar, and fat.” 

Dr Mukherjee also recommends cutting back on processed, wheat-based products such as bread, cakes, pasta, and biscuits. “These can spike blood sugar and contribute to weight gain,” she says. 

“Time-restricted eating - where you ensure a gap of 12 to 16 hours between your last meal of the day and your first meal of the next day - also works for some women.  A 16-hour gap was found to create weight loss without calorie counting in this 2018 study,” she explains. “You need to find out what works for you over time. We are all individual.”

Watch out for your alcohol intake too. “The sugar content is huge,” says Kate.  The liver finds it harder to break that sugar down in menopause so it can be stored around the middle. Alcohol can also aggravate symptoms such as hot flushes.”

Kate adds: “We all want a quick fix but that isn’t going to work in menopause. You have to make a commitment.  We need to feed and nourish the body without feeling restricted. Rather than cutting out food groups, eat more of the foods that nourish you, good fats and fiber.  Instead of focusing on weight loss, focus on how it makes you feel.”

For more on menopause, head to our feature on does menopause make you tired?

Does menopause cause hair loss? Hair loss is quite often associated with men more than women but it can affect both genders throughout life. Many women may start to notice changes happening to their hair as they get older, such as loss of mass and thickness or just a change in texture, and this could be down to menopause.

While some of the best menopause supplements include essential nutrients that can aid hair growth, such as vitamin A and zinc, it’s a good idea to understand exactly how hair loss can happen from menopause and ways to manage this. Most importantly, it shouldn’t be something you have to be embarrassed by and it’s helpful to remember you aren’t on your own. According to research published in the Menopause journal, more than half of women over 50 will experience hair thinning but early detection can be beneficial for women.

We know how important hair is to an individual and this is highlighted in the study above, which found 60% of the postmenopausal women had low self-esteem and this increased with hair loss. This is why we spoke to UK based doctor and leading menopause specialist, Dr Louise Newson, to debunk the important questions surrounding menopause and hair loss and ways to manage this if it happens to you.

Does menopause cause hair loss?

The answer to this question is yes, but it won’t affect everyone.

Dr Newson explains that oestrogen is an important hormone for improving hair growth and keeping the hair follicles healthy. So when levels of this hormone reduce during perimenopause (the transitional period before menopause) and during menopause, this can often lead to hair loss. She also mentions that hair can change in texture and many women will find their hair feels drier and coarser.

How does menopause cause hair loss?

Dr Newson says, “Hair is prone to aging and in women, hair follicles tend to shrink due to low oestrogen levels and so hair becomes finer. The total number of hair follicles also reduces and this can happen over the scalp and body.”

Perhaps you aren’t experiencing menopause yet but are aware of some hair thinning? Newson explains that some women have low iron levels as a result of heavy periods during perimenopause and this too can lead to hair loss. There are easy ways to increase your iron intake and this doesn’t mean you need to eat lots of red meat if you don’t want to. Red meat can be bad for your cholesterol levels (this can already increase from menopause), however, foods like beans, dark green leafy vegetables and dried fruit can all pack in iron into your diet. Plenty of these foods are included in various recipes featured in some of the best vegan cookbooks.

Will the hair grow back?

There are oestrogen receptors in every cell in the body, including in the hair and scalp. Replacing the low oestrogen by taking body identical Hormone Replacement Therapy (HRT) can be beneficial for hair growth and slow down or even stop hair loss in some women, Dr Newson added.

“The oestrogen is usually given as a patch, gel, or spray and women usually notice that the texture of their hair improves and their hair becomes thicker after a few weeks and months”, she adds.

The UK health care provider, NHS, states that HRT is a treatment available to help relieve symptoms of menopause by replacing hormones that are at a lower level as you approach menopause. However, it's best advised you consult your doctor first.

How can you take care of your hair during menopause?

Small daily habits can also make a difference when it comes to protecting your hair. Dr Newson says it's best to use a gentle shampoo and good quality conditioner. Women should also avoid intense drying as it can make their hair more prone to splitting.

“Wearing a hat on sunny days will protect the scalp and hair from UV damage. Colouring hair is not usually a problem. Eating a healthy, balanced diet will help, as will managing the cause of stress, and focussing on your wellbeing,” she points out. If you need more expert information about perimenopause and menopause Dr Newson founded the balance app that can help you track symptoms and create personalized health reports.

You can find out more about Menopause and anxiety: causes and how to treat it or we can answer your queries about does menopause make you tired?

Considering yoga for menopause? Focusing on moving your body through a series of poses and breathwork exercises are ideal for helping to ease uncomfortable symptoms and side effects of menopause. Common symptoms include, but are not limited to, fatigue, poor concentration, disturbed sleep, muscle aches, night sweats, and hot flushes.  

Yoga is proven to be an effective remedy to help reduce both physical discomfort and improve mental wellbeing during menopause according to a study cited in the Menopause International Journal.  

Importantly, as a natural part of aging, menopause is no longer a topic that can only be discussed behind closed doors.  It’s a subject that we should all be talking about more openly so we can understand how it affects each individual and share ways to help improve the experience for everyone. 

Whether you’re already taking the best menopause supplements and want to try out other ways to manage your symptoms, we asked expert yoga instructor, Sarah Highfield to share her top tips for practicing yoga when going through menopause. So, grab one of the best yoga mats and just keep reading. 

Yoga for menopause: what are the benefits?

Yoga and breathwork offers a multitude of benefits towards helping to ease both physical and menopausal symptoms.  While menopause can turn your daily routine upside down, here are some tried and tested tips to help restore some balance and a more stable routine back into your life.

Helps improve poor concentration

Yoga helps to improve poor concentration brought on by menopause by offering a moment in the day when you can put distractions to one side and focus purely on yourself.  Modern life means we are often caught up with work, or distracted by news, social media, television, or other digital media.  Through practicing yoga, you are encouraged to ignore your distractions and focus on slow physical movements along with controlled breathing. 

Helps to increase energy levels

Yoga can help to reduce fatigue and increase energy levels by stimulating your mind and decreasing cortisol levels - the stress hormone.  In research cited in the journal of Oxidative Medicine and Cellular Longevity, yoga was proven to slow cellular aging and decrease levels of cortisol.  The research identified a strong correlation between our energy levels, health, and the rate at which we age with our lifestyle choices.

Helps to manage hot flushes

Sitali pranayama is a yoga breathwork exercise that helps to cool the body down and calm the nervous system which can be applied when you’re experiencing hot flushes.  It is commonly known as the ‘cooling breath’ and works by adding moisture to the body and regulating body temperature.  The exercise is done by rolling the tongue into a circular shape and breathing through it like a straw.

Soothes muscle aches

Menopausal muscle and joint pain, commonly known as menopausal arthralgia, can be managed with the help of gentle yoga stretches, which keep the muscles flexible, and joints active and mobile. A study in the Biomedicine & Pharmacotherapy journal stated that practicing yoga regularly not only aids general mobility, but is gentle and low-impact, and also helps to push synovial fluid around the joints and strengthen the muscles which support the joints. 

Promotes an overall sense of wellbeing

A study carried out in the journal Maturitas supported the effectiveness of yoga for safely reducing menopausal symptoms. Practicing yoga regularly promotes an overall sense of well being by reducing blood pressure, increasing serotonin levels, encouraging a sense of serenity, easing anxiety, and stretching out the whole body.  

Which type of yoga is best for menopause?

The best style of yoga to practice for alleviating menopause symptoms is a mix of gentle vinyasa flow, with hatha and restorative, along with breathing exercises and meditation. If a gentle vinyasa flow is too dynamic, then it’s better to focus on hatha and restorative yoga. 

10-minute yoga for menopause sequence

Follow this simple 10-minute yoga sequence to soothe your body during menopause.  You have an option to do a vinyasa between each pose so that you can enjoy a yoga flow, or you can do the poses alone and make it a hatha style practice.

Yoga Pose One: Warrior Two

How to: Start with your right foot forward and your left foot behind, look down at your feet to check that your heels are roughly in line.  With an inhalation, lift your arms up so they are parallel to the floor and with an exhalation, bend your right knee so that it is above your right heel.  Keep your core lightly engaged, extend out through your fingertips and soften your shoulders away from your ears. Hold the pose for six-eight deep breaths in and out of your nose and then repeat on the second side.

Benefits: This empowering pose strengthens the legs, and stretches the hips & chest, along with soothing tight muscles. It also improves balance, circulation, strengthens the joints and energizes the entire body. 

Yoga Pose Two: Low Lunge

How to: Place your left foot forward and your right knee down on the floor (use a soft cushion under your back knee if needed).  On an inhalation, bring your hands into prayer position at your heart center, and on exhalation, sink your hips down and forward.  Keep your core lightly engaged and spine long. Hold the pose for six-eight deep breaths in and out of your nose and then repeat on the second side.

Benefits: Backbends are proven to stimulate the nervous system and release endorphins. The deep opening through the front of the body helps to relieve stress and boost energy. Many people find that stretching the front of the body also helps to free up the emotions and release tension. 

Yoga Pose Three: Revolved Head-to-knee

How to: Sitting on the floor, fold your left leg in and extend your right leg out to the side.  Reach out to hold onto your right big toe with your right hand, then stretch your left arm up and over, while gently rotating your torso up. Hold the pose for six-eight deep breaths in and out of your nose and then repeat on the second side.

Benefits: This pose has the calming benefits of a twist, as well as the mood-boosting advantages of a chest and shoulder opener. The stretch in the hamstring delivers a good release and provides the foundation for many other yoga poses. The pose can also help to soothe anxiety, depression, and fatigue. 

Breath Meditation

Research cited in the Journal of Clinical Interventions in Aging backs evidence that quality of life for menopausal women is greatly improved through yoga, pranayama (yogic breathing exercises), and meditation. One widely practiced pranayama and meditation hybrid is a breath meditation, which helps to bring your awareness into the present moment, breathe consciously and find your inner stillness. 

How to: Sitting comfortably or lying down, close your eyes and begin by focusing your breath. Try not to control your breath, but allow it to flow in and out as naturally as possible. Begin by noticing how it feels to breathe and observe where you feel the breathing taking place in your body. Next, listen to any faint sounds you make as you breathe and feel the subtle movements of your chest and abdomen. Think of the breath as cleansing, so you are breathing in fresh, clean air, and exhaling out stale, old air.  Try to stay in your breath meditation for a few minutes to start with, then over time, you may wish to increase the length of the practice.

Benefits: By closing your eyes, you can direct your attention inward and become fully present in the moment.  This simple meditation delivers an overall sense of focus and calm, which in turn helps to lower stress levels, reduce heart rate, reduce depression and manage pain.

The side effects of menopause include everything from hot flashes and sleeping problems to low mood and anxiety. Numerous studies have shown that one lifestyle factor can help with all these symptoms: exercise.

You may have already considered the best menopause supplements but research published in the journal Menopause looked at the menopause symptoms and physical activity levels of more than 6,000 Latin American women aged 40 to 59. The researchers asked about menopause symptoms, including hot flashes, irritability, insomnia, and depression, and how many times a week the women had recently engaged in at least 30 minutes of physical activity.

The researchers found that women who were sedentary (exercised fewer than three times a week) were 28% more likely to report severe menopause symptoms than those who exercised more. Sedentary women were 21% more likely to experience hot flashes. They were also 17% more likely to feel sad or depressed.

According to another study in the journal Maturitas, lifting weights and other resistance training could have a significant impact on hot flashes.

Menopausal women with at least four moderate or severe hot flushes or night sweats per day were randomized to a 15-week resistance training intervention or a non-workout control group. Hot flashes and night sweats were almost halved among the exercising women compared to no change in the control group.

If you’re looking to add strength training to your exercise routine, check out the best adjustable dumbbells or best kettlebells for home workouts.

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How does exercise help with menopause symptoms?

Exercise during and after menopause offers many benefits, including preventing weight gain and strengthening your bones. Loss of bone density after menopause is common and can increase the risk of fractures and osteoporosis.

The North American Menopause Society recommends exercising for 45 to 60 minutes three times a week to maintain bone strength. This should be a combination of weight-bearing exercises like brisk walking or jogging, strength training with resistance bands or weights, and balance work like yoga or tai chi.

Regular exercise at any stage of life can help you maintain a healthy weight, relieve stress, and improve your quality of life. If you are going through menopause, both cardio and strength training could help ease menopause symptoms.

The transition into perimenopause can cause women to experience various changes to their overall health and fitness levels. Exercise can be really beneficial for managing symptoms, especially when it feels uplifting to complete.

According to female health and fitness expert, Catie Miller says oestrogen declines as women go through menopause  which may increase their risk for certain things like osteoporosis. Things like the best vitamins for women over 50 or the best menopause supplements can help with this. 

Miller specializes in female-centric mind and body exercise and has built a fitness platform around this, called Oona Fitness, to help women of all ages to enjoy the physical and mental benefits of exercise. She recommends for oestrogen levels: "Getting foods rich in calcium and Vitamin D is very important. Great sources of plant based Calcium include spinach, broccoli, dark greens, sesame seeds, Tahini, pulses and fortified non dairy drinks."

But her big advice for women going through menopause is to find uplifting forms of exercise. Miller specializes in female-centric mind and body exercise and has built a fitness platform around this, called Oona Series, to help women of all ages to enjoy the physical and mental benefits of exercise.

Miller who is also a barre instructor says that women in their 40s and 50s should aim to work out three times a week. If you can manage more this is great as long as you diversify your training. "Focus on resistance, core, tone and supervised weight training," says Miller.

The hormonal changes that occur during perimenopause combined with a decrease in metabolism that occurs with age can cause women to gain weight, specifically around the abdomen and upper arms explains Miller. 

Moreover, the transition into perimenopause can see the following occur to the female body; a decline in muscle density, reduced muscle tone, higher fat mass, water retention and increased cholesterol levels. 

This 2020 study looked into women's views on using exercise to treat menopausal symptoms and all participants spoke positively about physical activity as a treatment for menopause. A majority reported it had improved their hot flushes, night sweats, and sleep quality. They also said both their physical and psychological well-being had benefitted from regular exercise.

Why not allocate three slots in your week for yourself, where you can take part in your choice of uplifting exercise to help alleviate any menopausal symptoms that you may experience.

Three types of uplifting exercises to try:

• Pilates
• Walking
• Light running
• Yoga

Try this 30 minute energising Pilates workout:

Women transitioning through menopause experience various different symptoms such as, hot sweats, night sweats, mood swings, chills and weight gain. While these are undesirable symptoms suffered by many, there is another menopausal health risk that might not have been on your radar - which is cardiovascular disease.

The more commonly known symptoms can play havoc with day-to-day life hence why many women resort to taking things like the best menopause supplements to try and reduce the intensity of side effects. 

In the meantime, science has been looking more closely into cardiovascular health among menopausal women to find out if they can better inform prevention strategies. 

Researchers at the University of Pittsburgh released a study, revealing that the duration of a woman's menstrual cycle leading up to the menopausal transition could indicate how at risk they are of developing heart disease. 

The study was published in the Menopause journal and found that women whose cycle length increased two years prior to their last menstrual period had better cardiovascular health than women who had more stable cycle lengths during this same period.

The lead author of the study Samar El Khoudary said, “Cardiovascular disease is the No. 1 killer of women, and the risk significantly increases after midlife, which is why we think that menopause could contribute to this disease.” 

The data shows that women with regular cycles prior to no longer havig a period due to menopause have a higher risk of cardiovascular disease compared to women with longer gaps between bleeding. 

El Khoudary said they couldn't confirm why this was the case but the findings suggest that high oestrogen may protect cardiovascular health in young women with short cycles, meanwhile the hormone could be less protective in older women.

Claire Snowdon-Darling, menopause and hormones expert, Head of The College of Functional Wellness and founder of kinesiology clinic, Balanced Wellness told us that bleed regularity is created by the amount of oestrogen we have in the body with lower levels causing gaps.

“The study posits that oestrogen is more beneficial in younger women than in more mature women. I would argue that this isn’t necessarily the case and more about what “type” of oestrogen is dominant in the body,” says Snowdon-Darling.

She explains that one common hormone imbalance in women is caused by ‘Xeno-oestrogens’, which are compounds that mimic oestrogen in the body and are created by exposure to pollution, plastics, pesticides, stimulants, toxic chemicals and blood sugar imbalances.

Therefore, Snowdon-Darling says you should ensure you have the right oestrogen in your body to make sure you are looking our for your cardiovascular health. Here are three tips from the menopause and hormones expert: 

• Keep blood sugars stable. This stops the stress hormone cortisol and the blood sugar hormone insulin becoming imbalanced and contributing to inflammation in the body which also causes xeno-oestrogens.
• Exercise. We all know that getting out of breath helps keep our heart healthy but exercise also promotes the happy hormones “endorphins” and also reduces our blood sugars. Making a daily habit of walking can help you to feel the benefits that regular exercise can have on your health - a pair of best walking shoes for walking might help to motivate you getting out the door.
• Eat a diet rich in good fats. Omega 3 from fish and seaweed is an essential fatty acid that contributes to good cardiovascular health. Avoid Omega 6 & 9 as these contribute to inflammation 

Mood swings, hot flushes, and night sweats are a few of the most commonly talked about symptoms of menopause. However, there are additional symptoms that are less talked about, and dry itchy eyes is one of those despite it being very prevalent among menopausal women.

Your body endures various hormonal changes during the menopause transition and is why women look to balance the symptoms with things like the best menopause supplements. 

The above can be great for targeting certain symptoms, but you might still be looking to find out why you are experiencing dry and itchy eyes specifically, and additional ways to calm down this irritation.

The symptom is medically known as Dry Eye Syndrome and, according to the Society of Women’s Health Research, 62% of perimenopausal and menopausal women suffer from it. Typical signs of the symptom include sensitivity to light, dryness, blurred vision and a gritty, sandy feel in the eyes.

The condition occurs when the eyes aren’t making enough tears or the tears dry too quickly depriving the eye of moisture, making it feel dry and irritable. It can also make your eyes appear red and puffy.

Francesca Marchetti, Optometrist from Rohto Dry Aid told us that women going through perimenopause and menopause are more likely to experience dry eyes for a few reasons:

“Firstly, from our 40s onwards the quantity and quality of hyaluronic acid produced by our bodies decreases. This hyaluronic acid is key in retaining moisture. Plus, as we get older the eyes produce fewer tears and these can be poorer quality too,” explains Marchetti.

Three tips to ease dry eyes during menopause

Think you suffer from Dry Eye syndrome? These tips from Marchetti and Rohto Dry Aid should help you ease the irritation:

1. 20 20 20: We need to give our eyes a break from screens every 20 minutes by looking at a distant object (20ft away) for 20 seconds and blink for 20 seconds – it’s called the 20-20-20 screen break rules – and that includes phones and tablets. Every time we blink, a film of tears spreads over the eye which helps to keep the eye smooth and moist. 
2. Catch some ZZZs: It’s during the hours that we are resting, that our body can repair and recover. That goes for our eyes too as the time they are closed is a period when they aren’t being forced to focus. Getting 7 to 8 hours of shuteye can allow for tears to be replenished and eyes to relax. Not getting enough quality sleep? Find yourself one of our best mattress topper entries to make winding down feel extra comfy.
3. Break the cycle: One of the most important things you can do to ease symptoms of dry eyes is to interrupt that vicious circle. You can do this with various eye drops that are sold over the counter, which will provides soothing relief and help hydrate and restore the tear film. 

Some of us are adopting a more plant-based way of eating, and now a new study reveals that women who are postmenopausal could benefit from this type of diet.

This study, undertaken by North American Menopause Society in the journal Menopause, looked at how a low fat plant-based diet, which also included soy, affected the frequency and severity of menopausal hot flashes.

Some women, who are going through menopause benefit from taking the best menopause supplements, while this research found that a plant-based diet, with soy, reduces hot flashes by 84% - reducing them from around five a day, down to one or less a day.

If you've never considered a plant-based diet and you're not sure where to start, check out our guide to the best vegan cookbooks. 

The Women's Study for the Alleviation of Vasomotor Symptoms (WAVS) split their participants, who all suffered from two hot flashes or more a day, into two groups - with some in the intervention group, where their diet consisted of a low-fat, vegan diet, where they were also given half a cup of soybeans to eat a day. While the other group made no changes to their diet.

Both groups then used an app to record if and how their symptoms changed throughout a 12 week period. In the intervention group 79% of women who took part said that their moderate-to-severe hot flashes decreased by 84%, while by the end of the study over half (59%) reported that their moderate and severe hot flashes had completed stopped. The group who made no changes to their diet reported no changes to their symptoms.

As well as hot flashes being alleviated Anna Mapson, Registered Nutritional Therapist and owner of Goodness Me Nutrition says that a well balanced plant-based diet can also be good for your gut: "During the menopause fluctuating hormones may affect digestion leaving you with constipation or diarrhoea so increasing fibre from whole grains, vegetables and fruits can help maintain a regular bowel movement."

However, she also warns that a vegan diet could mean you miss out on other nutrients, such as Omega 3: "Oily fish is the best dietary source of omega 3, so vegans can take an algae-based omega 3 supplements which could help with dry skin - a common side effect with the drop in oestrogen around menopause."

Menopause can be a very difficult time for women. With declining oestrogen, the loss of periods, hot flushes, headaches, mood swings, anxiety and depression, it's essential we understand what's going on. 

However, menopause is often treated as a bit of a taboo subject, which leads to a lot of surprises and mysteries for many women, who sometimes don't understand or misdiagnose what they're going through. Throw in the idea of a separate "perimenopause" period, and things start to get really confusing. 

Enter Dr Zoe Schaedel and menopause dietician Nigel Denby, who took to our Instagram with a comprehensive breakdown of the subject. What is the difference between menopause and perimenopause, and how can you tell if this is what you're going through? How can you manage this period in your life and start prioritising your own needs again?  

While watching, check out our list of the best menopause supplements to help you manage symptoms more effectively. 

Watch the experts' talk on menopause and perimenopause here:

Menopause: hormonal changes in your body and the perimenopause period

Schaedel says menopause is "the phase of life which occurs after your periods have stopped. The diagnosis of menopause is made one year after your last period. What people are less aware of is the lead-up to that point. In order to get to the point in which your periods stop, all sorts of hormonal changes have to happen, you could call it hormonal chaos.

"When that happens, it can be five or even ten years before the last period, and that time is called the perimenopause. People don't know what to expect, there isn't much good education on it."

The average age for the last period is about fifty, according to Shaedel and Denby. The perimenopause is, on average, around five years before that. But so many symptoms can occur during this period, even before your period has stopped, that might lead to a misunderstanding of what's happening in your body. 

Shaedel says hot flushes occur when oestrogen begins to drop. However, much more commonly in the perimenopausal period, people can notice they're getting more anxious and less confident. Sleep is often disturbed – sometimes sleep goes out the window for seemingly no reason, and this is often the result of hormonal changes.

Often these changes are confused with depression and anxiety, which can lead to a misdiagnosis and mistreatment with antidepressants. Because this is a hormonal change rather than clinical depression, antidepressants won't address the root cause of the problem. However, this is conditional to the "roller coaster" of hormonal variations, and will naturally ebb and flow as will the other symptoms such as dry skin and hot flushes. 

Medical and fitness professionals alike agree on the importance of exercise in menopause.

The menopause doesn’t just mark the end of a woman’s menstrual cycles; it’s also a period of transition, in which you may experience exhausting physical and mental symptoms that can really affect day to day life.

Common issues include loss of muscle mass and bone density, sleep challenges, a slower metabolism and menopausal weight gain, often linked to changes in appetite. One study confirmed decreased levels of the satiety hormone leptin, can lead to an increased appetite. Some women also experience bladder issues and constipation.

Managing the symptoms takes many forms. Many women turn to hormone replacement therapy (HRT), whilst others rely on the best menopause supplements to tackle general or specific symptoms. However, lifestyle - include exercise during menopause - also has a role to play.

However, unfortunately many of the symptoms can impact a woman’s menopause exercise routine - but are also the reason why it's essential to keep (or start) working out during this life stage.

‘Some women find these menopausal changes actually make it challenging to stick to exercise,' says Antonietta Vicario, VP of Talent and Training at fitness brand P.volve. 'But it’s imperative to move to help mitigate some of the effects of menopause. 

'By incorporating exercise into one’s lifestyle, they can minimise the effects of the menopause and keep their mind and bodies working optimally.'

Below, we explore some of the best menopause exercises you can do during this time to help ease symptoms and maintain good health. Vicario also shares a simple four-move at-home menopause workout to try.

Strength training

Women going through the menopause loose bone density and muscle mass year over year, which leads to a slowing of the metabolism. This is thanks to a decline in the hormone oestrogen.

The answer? Strength training. Resistance-based exercise (i.e those that incorporate some sort of weight to intensify the moves) is key to promoting healthy bones and maintaining muscle mass, which in turn can help boost a flagging metabolism.

In addition, having a greater amount of muscle mass on the body allows our body to burn more calories when resting, which can help manage menopausal weight gain.

During menopause, aim to do three 30 minute resistance-based workouts a week. These don’t all have to incorporate actual weights; they could be bodyweight movements such as squats, lunges and push ups (take a look at our 30-day squats challenge or bodyweight workout plan for inspiration.)

However, adding an extra level of resistance to your workouts with, for example, a set of adjustable dumbbells or one of the best kettlebells, adds a greater challenge and helps build up muscle quicker.

Cardio exercise

Cardio - also known as aerobic exercise - is essential at any age, including during menopause. It raises your heart rate, which in turn makes your blood pump faster.

‘Cardiovascular activities help build and maintain a strong and healthy heart, which is very important for women as they age,’ says Vicario. ‘This type of exercise also helps reduce some of the weight gain women may experience as their hormone levels change in menopause.’

What's more, cardio exercise is a great way to release feel-good endorphins, helping to swerve the changes in mood that can occur during the menopause.

Vicario recommends trying walking, jogging or swimming around three times a week for at least 30 minutes - all great cardio options.

However, there are many other types of cardio exercise you can do. At the gym, hop onto the big pieces of equipment: treadmills, rowing machines, exercise bikes and elliptical machines are all great means of getting your heart rate up.

Alternatively, sign up for a class or download one of the best fitness apps to do sessions such as body pump, Zumba and aerobics. You could also try any of our fat-burning best exercises for weight loss.

Yoga and Pilates

Many menopausal women find that practicing yoga and Pilates has a positive impact, in particular when it comes to maintaining supple joints.

‘During the menopause, women may experience decreased spinal mobility,’ explains Vicario. ‘Whole body movements that focus on mobility, taking the joints through large ranges of motion are great for overall joint health. Both yoga and Pilates help promote joint health for women in menopause.’

If joint issues are a particular concern for you, take a look at our list of the best supplements for joints.

Taking a joint through its full range of motion also helps to maintain flexibility, so women can stay active and move freely as they age (our list of flexibility stretches can also be beneficial here).

Pilates in particular is also great for strengthening the pelvic floor. This is essential, Vicario says, to help the 'changing environment in the vaginal tissue due to lower levels of progesterone and oestrogen surrounding menopause, which can affect pelvic organ support and function.’

What's more, a 2012 study found evidence that yoga can help to relieve the psychological symptoms of menopause, such as irritability, depression, anxiety and sleep problems.

If you're new to yoga or Pilates, the good news is that it's really easy to get started - all you'll need is a suitable mat (such as one of the picks on our list of the best yoga mats) and some comfortable workout clothes. Check for local classes, or else try one of the numerous free sessions available on YouTube, such as this one by popular yogi Brett Larkin...

At-home menopause exercise plan

Prefer to workout in the comfort of your own home? Vicario has devised an easy menopause exercise plan features four simple moves you can do at home that will help mobilise, strengthen and stabilise. She recommends doing each move for 60 seconds on each side.

All of the moves will strengthen the pelvic floor and improve mobility and posture. They've also been specifically selected to target common physiological issues in menopause, as Vicario explains.

‘Women in the menopausal age bracket often have increased incidence of gluteal tendinopathy (constant pain near the side of the hip), plantar fasciitis (heel pain), and rotator cuff tendinopathy (pain and inflammation near the shoulder). 

'Targeted hip, gluteal and abdominal strengthening, as well as shoulder and postural exercises can help combat some of these gradual changes that occur as our hormone levels shift.'

If you're particularly keen to work on your core, you could also try our list of the best workouts for abs.

For some of the moves, Vicario has incorporated the P.volve P.ball, an inflated ball that targets the inner thighs, abs, glutes and pelvic floor muscles. Whilst this will intensify the move, all of the exercises can be practiced without the use of the ball.

Leg lifts at 6

• Lean your upper body forward on a diagonal, with a long spine, abs held in tight and hands in prayer. 
• Extend one leg straight back behind you and lift and lower the leg, lengthening and stretching behind your knee.  
• Lift as high as you can without compromising your lower back - if your back starts to arch, you have gone too far so always prioritise length over height. Feel free to hold onto something to work up stability if needed! 
• By standing on one leg, you are building bone density in the standing leg, overall stability and strengthening the glutes.

Fire hydrant

• From your staggered position, lift one shin up and begin to lift and lower the leg out to the side, squeezing the ball (if you are using it) and engaging through the pelvic floor on the way in. 
• You are working your balance, pelvic floor, abdominals and bone strength all in one. If you need to hold onto something for balance that is absolutely fine.

Side plank

• Come to one forearm and outstretch your legs.
• If needed, you can always keep your bottom knee on the ground. 
• Slowly lift and lower your hips, and engage through the pelvic floor as you lift.

Bridge

• Lie on your back with your knees bent, pressing your feet into the floor and with your arms relaxed by the sides.
• Press your hips up to the ceiling (squeezing the ball as you do so if you're using it), strengthening the glutes and deeply activating through the pelvic floor muscles. 
• Lower down to a hover and repeat. 
• Be sure to keep the abs scooped out as you lift and lower.

It’s no secret menopause symptoms can very greatly from person to person. Some people don’t find they gain much weight at all, while others find it difficult to keep the pounds off. Some get severe hot flushes, while for others, the sensations are very mild. It makes for a stressful time of life.

However, although every woman experiences this time period differently, science has determined how to mitigate some of the most common sysmptoms found in menopausal women. From the best menopause supplements for a particular symptom to tackling menopausal weight gain head-on, this is how to mitigate its impact on your day-to-day life. 

Common menopause symptoms:

• Hot flushes
• Night sweats
• Mood changes
• Weight gain
• Sleep disturbances
• Declining collagen
• Vaginal dryness
• Headaches and migranes

 First… a word on HRT

It’s impossible to talk about menopause without acknowledging the controversy over HRT, or hormone replacement therapy. There are reports HRT can cause an increase in risk for some types of cancers, such as breast cancer. However, according to the UK's NHS, HRT can relieve most menopausal symptoms – including hot flushes, mood swings and reduced sex drive –  and that recent evidence shows the risks to be small.

“For the majority of women who start taking HRT when they are under the age of 60, the benefits of HRT really do outweigh any risks,” says Dr Louise Newson, a leading menopause specialist. “This means it is safe to take and can provide positive health benefits, especially for your bones and heart.”

Whether you chose to take HRT is ultimately a personal choice, made with your doctor and it should, in any case, be used in conjunction with other healthy lifestyle changes. So what else can help?

How to tackle hot flushes and night sweats 

Hot flushes – caused by fluctuating hormones – can cause embarrassment, anxiety and sleep disruption.

• Try CBT: As stress can worsen flushes, Women’s Health Concern (the patient arm of the British Menopause Society) suggests Cognitive Behavioural Therapy to help reduce the intensity of flushes, as well as keeping a symptom diary to track potential triggers. 
• Make diet changes: Dr Newson points to a 2019 study in Climacteric which found an increased intake of oily fish and vitamin B6 may also help improve flushes. The best fish oil supplements and best vitamins for women over 50 can also confer these benefits. 

How to mitigate mood changes

Fluctuating hormones can cause psychological symptoms – such as mood swings, anxiety, depression and brain fog – and the link to the menopause can sometimes be missed. 

• Seek support: Not knowing why you are feeling this way can cause its own anxiety so speak to your doctor and do your research. Try the Balance App created by Dr Newson to provide menopausal women with support and advice. Dietitian and menopause specialist Nigel Denby also hosts an expert-led facebook group, Harley Street at Home, with regular ‘ask the expert’ sessions.  
• Vitamin D: “Many researchers believe vitamin D is vital to healthy brain function and studies suggest it might play an important role in regulating mood and warding off anxiety and depression,” says Dr Newson. If you find yourself working in a dingy office space, the best SAD lamps mimic sunlight, which has been proven to boost mood. 

How to put the kibosh on menopausal weight gain

“There’s good evidence 75% of women will gain up to 10kg in perimenopause,” says Nigel. “This is predominantly due to declining oestrogen (which changes the way women lay down fat) as well as a steady decline in muscle tissue, which slows metabolism."

• Balance hormones: "If you're feeling ghastly - with hot flushes and mood swings - it's difficult to embark on the lifestyle changes needed. Balancing your hormones and HRT can help you get to a place where you are able to make the necessary changes." 
• Get holistic: “It’s tempting to go harder at what worked in your 20s and 30s but your body is changing,” says women’s health coach Baz Moffat. “We become more susceptible to the stress hormone cortisol around menopause, which encourages our bodies to hold onto fat.   
• "This can be further spiked by missed meals, disrupted sleep and exercise that's too long and hard. Instead of another HIIT session, you might need some restorative yoga to help you sleep, or to manage your blood glucose levels by switching to more complex carbs.” 

How to avoid sleep disturbances

Tossing and turning all night? Sleep disturbance is common from the perimenopause onwards. 

• Progesterone and magnesium: “Natural progesterone can improve sleep by regulating neurotransmitters in the brain. It works alongside melatonin (a naturally produced hormone) to control your body clock,” says gynaecologist and women’s health specialist Dr Saadia Meyer. 
• “Magnesium will also support those pathways. Since melatonin levels naturally reduce from perimenopause, increasing your intake of magnesium now can be particularly beneficial.” 

How to lessen the impact of declining collagen

Declining oestrogen leads to a decline in collagen – cue wrinkles, sagging and dry skin.

Protect your collagen: “The most important changes you can make are to cut out habits that cause the skin collagen levels to decline, such as damaging sun exposure and smoking,” says consultant dermatologist Dr Sajjad Rajpar. “Once these issues are addressed, serums containing anti-aging ingredients that can help preserve the skin collagen levels - including topical retinoids and vitamin C - can be helpful.” 

Eat more fruit and veg: “Our body can manufacture collagen from vitamin C so make sure you’re eating plenty of fruit and vegetables,” says Dr Glenville. Try one of the best vegan cookbooks for loads of fruit and veg-based recipe ideas, even if you're not going vegan day-to-day. 

• Protect your collagen: “The most important changes you can make are to cut out habits that cause the skin collagen levels to decline, such as damaging sun exposure and smoking,” says consultant dermatologist Dr Sajjad Rajpar. “Once these issues are addressed, serums containing anti-aging ingredients that can help preserve the skin collagen levels - including topical retinoids and vitamin C - can be helpful.” 
• Eat more fruit and veg: “Our body can manufacture collagen from vitamin C so make sure you’re eating plenty of fruit and vegetables,” says Dr Glenville. Try one of the best vegan cookbooks for loads of fruit and veg-based recipe ideas, even if you're not going vegan day-to-day. 

Take on vaginal dryness

“Oestrogen helps maintains the elasticity and strength of our body tissues,” says Dr Meyer. “As oestrogen depletes it can cause vaginal dryness, discomfort and repeated urinary tract infections.”

• Topical oestrogen: “Topical oestrogen – applied locally to the area – is effective and safe so speak to your doctor,” says Dr Meyer.
• Omega 3: Increasing the oily fish in your diet may also help. “Omega 3 fatty acids can help keep everything lubricated," says Dr Glenville. 

Eliminate headaches and migranes

According to Women’s Health Concern, headaches affect 90% of peri and menopausal women. 

• Mirena coil: “If your headaches are cyclical and linked to troublesome periods, the Mirena coil may make them less likely to occur,” says Professor Anne MacGregor, a headache and women’s health specialist. 
• The right HRT: “HRT can help reduce the likelihood of migraines by controlling menopause symptoms but some forms can create hormone fluctuations which trigger migraines,” says Professor Anne MacGregor. She recommends women ask their doctor for oestrogen patches or gel. “These maintain stable hormone levels with few fluctuations”.

Are menopause symptoms affecting your day-to-day life? If so, you're not alone: a new report has found in the UK, nearly two-thirds of women (62%) who experienced menopause symptoms said that this has impacted them at work. For 18 to 44 year olds, that number rises to four in five, or 79%. 

The research, conducted by analysts from Opinium and published by telecoms company Vodafone, also found a third (33%) of those who had symptoms said they hid this at work, and 50% felt there is stigma around talking about the menopause. 

Menopause is something that happens to every woman, and the age in which it occurs and the strength of the symptoms varies from person to person. The average age the menopause occurs in women is 51, but it generally occurs after the age of 45, according to the UK NHS. 

Some symptoms can include increased feelings of stress, anxiety and depression, hot flushes, dryness, menopausal weight gain, excess sweating, and a decline in collagen, which can cause wrinkles and sagging skin.

As mentioned above, the intensity and variation of these symptoms varies from person to person. Everyone experiences the menopause differently – but all women experience it, so it's time we busted the stigma around it.

The study found two-thirds of respondents believe there should be more workplace support in place to help women during this time in their lives. This could include mental health support, flexible working, sick leave or other initiatives.

In the meantime, you can safeguard your own health with our best menopause supplements and the best vitamins for women over 50. Because menopause symptoms can vary so wildly, different supplements are needed to counteract them. Meanwhile, top vitamins can keep you fighting fit, healthy and active during this tough time, as can the best supplements for joints.

Lockdown has led to many women going through menopause without the usual network of support. Menopause can be a difficult time in the life of women: according to one study, published by Pfizer researchers in the Journal of Women's Health, menopause coincides with (or causes) "significantly higher work impairment, and healthcare utilization than women without menopausal symptoms.

"Depression, anxiety, and joint stiffness were symptoms with the strongest associations with health outcomes." Some women find this period of their life very easy to get through, and it's over and done with in a matter of a few months. Others, on the other hand, experience symptoms for years before the menopause actually occurs, during a time technically known as perimenopause. 

If you're worried about the menopause, there are a few things you can do: the best menopause supplements can help, while the best vitamins for women over 50 can keep your general health topped up during this difficult time. 

There's no doubt it can be hard not just for health reasons, but for economic reasons too, as some women need to seek medical treatment or find themselves unable to work. However, there's even more difference in menopauses which we don't often hear about, as ethnicity and race can also impact its effects on women. 

Dr Nighat Arif, a GP with Specialist Interest in Women’s Health, said: “The menopause is still in some cases, poorly understood or shrugged off, especially in ethnic minority groups. There is little research dedicated to the experience of the menopause in ethnic minority communities and because of this, the menopause is perceived as ‘white, middle-class problem’ among this community of women."

Karen Arthur, who hosts the "Menopause While Black" podcast, said: "The menopause movement needs to open up. It isn’t a polar nor divisive landscape, it shouldn’t be viewed as the black vs white experience, we just need more black women in the limelight talking about it.

“Even now, the landscape remains predominantly white, and middle class. We have to be able to see ourselves, to feel heard. Beyond optics, I want to see more research into black and ethnic minority experiences of the menopause. I want people to ask questions and keep asking. If we diversify the landscape, everybody wins.”

The Study of Women's Health Across the Nation found black and latina women reach menopause at 49, two years earlier than the average age. There are also differences in the way women experience hot flashes: white women are said to experience hot flashes for around six to seven years, up to three years less than black and latina women. A study from the American Journal of Medicine found American Idian women could experience hot flashes for even longer. 

If you’re struggling to lose weight in menopause, let us assure you: it’s not all down to overeating. 

Hormonal changes, broken sleep, stress and reduced muscle mass can all play into menopausal weight gain. So to lose weight in menopause you need more than just a diet - you need to understand your body. 

Below we talk you through some of the root causes of menopausal weight gain, along with the best diet and exercise approaches, so can you start to work with your body instead of against it.

• Best menopause supplements
• Best vitamins for women over 50
• Best supplements for joints

Why is it hard to lose weight in menopause?

There are myriad factors that may make it harder to lose weight during menopause. 

First of all, there’s the fact that the fat cells contain a weak form of oestrogen. 

“Women’s bodies need oestrogen and when those levels start to decline during the perimenopause and menopause, the body can try to create more by building up fat stores,” says GP and menopause specialist Dr Louise Newson. 

“Menopausal women also respond differently to sugar and are at greater risk of becoming insulin resistant, which can raise the risk of diabetes as well as weight gain.” 

And that’s not all. Nutritionist Emma Ellice-Flint explains that with less oestrogen to calm our sympathetic nervous system, we are more likely to feel stressed in the menopause. 

“Stress causes the body to release the hormones cortisol and adrenaline which, in turn, release glucose (sugar) into the bloodstream. We generally don’t need the extra glucose, because we are not fleeing or fighting an invader, so our body lays it down in abdominal fat cells.”

Add to that common menopause symptoms such as disturbed sleep (“studies show that poor sleep leads to poor food choices the next day,” says Emma) and joint aches that can make us less likely to exercise, and you’ve got a perfect storm for weight gain.

And as if the hormonal battle wasn’t enough, Dr Sally Norton, a surgeon and weight-loss consultant, adds: “There is a steady decline in muscle mass as we age (around 8% per decade after 40 - unless we compensate by exercising). 

"Since muscle burns more calories than fat, less muscle means less calorie burnt and more weight gain. Plus there’s some evidence that lower levels of ‘fat-burning’ brown fat may contribute to the middle-age spread, too.”

Best diet for weight loss in menopause

Changes to your diet can help when it comes to weight loss in menopause. Consider trying the following:

• Reduce sugar and carbs

Nutritionist Penny Crowther recommends reducing sugar and grain-based carbs such as bread, pasta, rice and also potatoes to help reduce the glucose in our system and balance insulin. 

“Faulty insulin metabolism means fat is more likely to be dumped around the middle," she says. "Fasting overnight for 12-14 hours can help too.”

• Up your intake of healthy fats

“Our bodies need healthy fats such as extra virgin olive oil, seafood, nuts, seeds and avocados," advises Emma. 

"If we don’t get enough we will crave more food, probably leading us to eat more sugar and simple carbohydrates,” she says.

• Eat more phytoestrogens

Include more foods containing phytoestrogens in your diet, such as soy (e.g. organic tofu), legumes, pulses, beans, wholegrains and flaxseeds. 

“Phytoestrogens can have a beneficial oestrogenic effect in the body,” says Emma. “They lock on to oestrogen receptors and produce a weak oestrogen effect which may help ease some of the menopause symptoms that are leading to weight gain.”

The best exercises for weight loss in the menopause

The following workouts are amongst the best exercises for weight loss in menopause:

• HIIT

“High-intensity Interval training can be really effective exercise for menopausal women as it has been shown to help improve insulin resistance and  reduce abdominal fat,” says Emma.

• Yoga and Pilates

Both yoga and pilates are great for relieving stress and reducing those glucose-releasing hormones cortisol and adrenaline.

• Resistance training

“Counteract the decline in muscle mass by using weights or bodyweight to build up your muscles, which will burn more calories,” says Dr Norton. 

• Outdoor exercise

“Studies show that exercise, especially in the cold, can help increase fat-burning brown fat,” says Dr Norton. Why not follow the lead of The Gower Bluetits and create your own cold water menopause swimming group? 

Penny has also been a keen outdoor swimmer for over 30 years. She says: “There are lots of claims made about the benefits of cold water swimming, including strengthening the immune system, improving circulation, reducing stress, increased calorie burning and boosting oestrogen levels, some of which are supported by science."

Expert tips for menopause weight loss

• Consider HRT

Dr Newson advises that, since declining oestrogen is likely contributing to weight gain, hormone replacement therapy can often help improve things.

• Don't go it alone

“Weight gain should be addressed in the context of a proper menopause consultation,” says Dr Deborah Lee of Dr Fox Online Pharmacy. 

“We know that poor sleep, tiredness, mood swings, anxiety and depression cause emotional eating. The NHS offers help and support which can be accessed by seeing your GP so don’t try to go it alone.”

Think menopause symptoms and your first thoughts are probably hot flushes, night sweats and mood swings. But menopause joint pain can be a common symptom at this time too. 

In fact, one study found up to 40 per cent of women may be affected. 

You may not link aches, pains and stiffness with menopause – lots of women assume it’s just part of the ageing process, or down to being less active, and struggle on. But hormone changes at menopause are a major cause – and fortunately, there are steps you can take to ease the discomfort.

• Suffering with other symptoms? Try the best menopause supplements
• Best vitamins for women over 50: a guide

Below, we explore the connection between menopause and joint pain and look at ways to ease it, including which exercises can help and the best supplements for joints.

What’s the link between menopause and joint pain?

‘Declining levels of the hormone oestrogen lead to a reduction in collagen – a key component of the connective tissue that supports joints,’ says consultant rheumatologist Dr Rod Hughes. 

‘Dropping oestrogen also results in loss of cartilage and an increase in inflammation. All of this can cause joint pain and stiffness.’ 

What’s more, he says, joint symptoms can actually be among the first signs of menopause. ‘You may experience them before you notice other symptoms because oestrogen starts to decline a few years before the menopause.’

There can be other contributing factors, such as menopausal weight gain. It’s common to gain kilos in midlife, and if that puts you over a healthy weight, it may put a strain on your joints. Plus, menopause can lead to anxiety and insomnia (you may be under a lot of stress for all sorts of reasons at this time of life), which can result in tense muscles, again connected with aches and pains. 

When to see a doctor about menopausal joint pain

You should always consult your doctor if you notice new persistent aches and pains. They can rule out other causes and may be able to suggest a plan of action, including physiotherapy and painkillers, if you’re in a lot of discomfort. 

They can also prescribe HRT, which replaces some of the oestrogen you’ve lost. That may help improve your joint pain, but lots of women don’t want to take HRT, or can’t, because they have risk factors such as a history of breast cancer. 

Whatever your doctor suggests, making some lifestyle changes is also key to managing joint aches and pains. 

Get moving to maintain healthy joints

It might be the last thing you feel like doing when your joints are sore, but staying active to ensure healthy joints is one of the best things you can do to ease joint pain.

‘Exercise helps synovial fluid circulate in the joints and increases blood flow,’ says Hughes. ‘That boosts oxygen and nutrient supply to the joints.’ 

It also helps control your weight and lifts your mood, so can go a long way towards managing stress and anxiety, too. 

Hughes suggests choosing activities that don’t put too much pressure on your joints, while keeping them flexible. Swimming, yoga and Pilates can be particularly helpful. 

Stay hydrated

Dehydration can worsen menopause symptoms, including joint pain. It can also lead to a build-up of uric acid, which may exacerbate inflammation. Aim for around 1.5 litres of fluid daily. It doesn’t all have to be water – teas, broths, milk (both dairy and plant) and sugar-free squashes can count towards your quota too. 

Choose anti-inflammatory foods

Controlling inflammation in your body can help manage menopausal joint pain. And your diet’s a key part of that. 

Hughes recommends a generally balanced diet, with lots of fruit and veg. Nuts, leafy greens, olive oil and oily fish are all particularly useful to include as they have anti-inflammatory properties. 

Also check out our guide the the foods to avoid with arthritis if you suffer with the condition.

Try menopause joint pain supplements

Topping up with supplements can be a good idea if you’re not getting all you need from your diet (and let’s face it, most of us don’t). 

Consider an omega-3 supplement if you’re not eating at least one portion of oily fish weekly – omega-3s help reduce help reduce inflammation in the joints. Veggie or vegan? Go for an algae-based omega 3 supplement instead. 

Although no specific link has been found between low vitamin D levels and menopausal joint pain, it’s always worth taking it for general joint and bone health, particularly in the darker months, when we don’t make enough from sunlight. 

Finally, Hughes recommends a supplement containing GOPO, a galactolipid found in rosehips – a small study found this reduced joint pain and stiffness in menopausal women.

Found this helpful? Check out our feature on menopause itchy skin: tips for relief.

When most people think about the menopause they think hot flushes and night sweats. What’s less widely known is menopause and anxiety can go hand in hand. 

According to research by Nuffield Health, a third of women with menopause symptoms say they suffer from anxiety, and one in four say they are struggling to cope with life.

“Hot flushes and night sweats are often the symptoms that bother my patients the least,” says GP and menopause specialist Dr Louise Newson. "It is the symptoms other people can’t see, the psychological symptoms, that lead to the most difficulties.” 

• How to avoid menopausal weight gain
• A guide to the best vitamins for women over 50

So what is it that makes women more susceptible to anxiety in menopause and what can we do about it? Below we explore the connection in more detail, and answer questions including what treatments are available and whether menopause supplements can help.

What causes menopause anxiety?

Ss ever, it's a lot to do with hormones. As women enter the perimenopause, levels of oestrogen and progesterone start to fluctuate and decline, as does testosterone. This can have a huge impact on the mind as well as the body - especially if we aren’t tuned in to what’s going on. 

Dr Deborah Lee of Dr Fox Online Pharmacy explains: “Oestrogen plays an important role in many of the brain's functions, including mood and emotion. Progesterone, meanwhile, is known to ‘switch on’ the brain’s GABA pathway (which is the brain’s inhibitory system to help cope with anxiety and stress) while testosterone increases our level of ‘happy hormone’ serotonin. 

"With all these hormones fluctuating and declining it’s no wonder so many women are left feeling anxious.”

A lack of education can make matters worse, says psychotherapist and menopause expert Diane Danzebrink. “If women don’t understand what’s happening to them, making the connection to menopause, then all those feelings can be intensified.” 

What are the symptoms of menopause anxiety?

Menopause anxiety can manifest in lots of different ways and is experienced differently by different people. Diane says these can include:

• A racing heart
• Repetitive thoughts
• A churning stomach
• A feeling of dread

It might also feel different depending on the time of day. “Menopause anxiety can often be worse early morning, when oestrogen is slightly lower,” says Dr Newson.

It’s not always easy to know if your anxiety is linked to menopause, especially if you are using contraception that alters your period. A menopause symptom checklist can be helpful, to see if you have any other menopausal symptoms. You can then take that to an appointment with your doctor. 

How is menopause anxiety treated?

Dr Newson believes hormone replacement therapy (HRT) to be the best treatment for menopausal symptoms. 

“Many women are scared about HRT - particularly in relation to breast cancer - but the small increased risk of breast cancer that has been demonstrated in some studies is lower than the increased risk of breast cancer if you are overweight or drink a couple of glasses of wine a night."

She adds: "Studies have shown that women who start HRT when they are under 51 years of age  - or who don’t take progestogen (so those women who have had a hysterectomy) - do not have any increased risk of breast cancer.” 

“Taking HRT actually reduces your future risk of diseases such as osteoporosis, heart disease and diabetes. So, in addition to helping you feel better, taking HRT is actually a real investment for your future health."

Diane agrees and recommends asking your doctor for the newer, ‘body identical’ HRT. “It has the same molecular structure as the hormones we produce naturally and is plant-derived (from the root vegetable the yam). Recent studies have shown that taking body identical oestrogen and progesterone for five years showed no increased risk of breast cancer,” she says.

Natural remedies for menopausal anxiety

Not keen on HRT, or simply looking to supplement it with more natural remedies? There are a variety of avenues to explore, including: 

• Supplements
• Lifestyle changes
• Cognitive behavioural therapy (CBT)
• Breathing and relaxation
• Support groups
• Aromatherapy

Supplements

“Some women do find different supplements useful - but the choice can be bewildering,” says Dr Lee. “Take advice from your doctor as even natural products are not without risk. There’s research to suggest that isoflavones - plant-based oestrogens - which include red clover, can reduce menopause anxiety but they are not recommended for women with a history of breast cancer”

Lifestyle changes

Dr Lee stresses that lifestyle changes can make a big difference. “Stopping smoking, losing weight (if you are significantly overweight), reducing alcohol and caffeine consumption, eating a healthy balanced diet and taking regular exercise have all been shown to improve menopausal symptoms,” she says.

Cognitive behavioural therapy (CBT)

“By understanding the changes to your body and developing a positive approach to dealing with these symptoms many women obtain significant improvement,” says Dr Lee. For those based in the UK, CBT is available on the NHS - although wait times can be long.

Breathing and relaxation

“Simple breathing techniques, yoga and mindfulness apps can also help,” says Diane. Check out our how to meditate guide for tips and advice.

Support groups

Finding your 'tribe' can help you share experiences and make you feel less alone. Diane recommends talking to friends or joining a support group such as the Menopause Support Facebook Group. “You don’t need to go through this alone,” she says.

Aromatherapy 

“The use of aromatherapy oils, like lavender, may help with poor sleep, promote relaxation and improve symptoms of anxiety or depression, says Dr Newson. “Although little is known about the effect of aromatherapy on menopausal symptoms, any therapy which allows you to relax and focus on yourself as an individual is an investment in yourself and can help you cope better with menopause symptoms.” Pick one of the best diffusers for essential oils to bring the benefits of aromatherapy into your home.

A varied, balanced diet is a must to support your overall wellbeing, whatever your age and life stage. But there are particular things to bear in mind when it comes to a healthy menopause diet. 

Eating right at this time can help you keep to a healthy weight, manage symptoms and look after your health in the long term, too. Here are some of the key things you need to know about following the best diet for menopause. 

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Avoid menopausal weight gain traps

The reasons behind menopausal weight gain are complex and not all related to hormones, according to The Menopause Doctor, Dr Louise Newsom, who explains you lose muscle at around eight per cent per decade after 40. That’s an issue because muscle singes energy, so losing it means your metabolism slows. 

You may be less active than you were when younger, and your body needs less energy now - but you’ll probably still eat the same amount of calories. Additionally, if you’re stressed with work and family duties, and/or hormonal changes are bringing you down, you may turn to comfort eating.

The drop in oestrogen at menopause has been linked with gaining fat around the middle, too, so you may find your shape changes, even if you haven’t actually piled on many more pounds. Avoid fatty, sugary, processed foods, which can contribute by loading you up with excess empty calories – a diet high in nutritious whole foods is best at menopause. Watch your portion sizes – you probably don’t need as much food as you did when you were younger.  

Focus on bone-health boosters

One in two women over 50 experience fractures due to weak bones, as a result of losing the bone-protective effects of oestrogen. Dairy is rich in calcium - if you have a glass of milk, a matchbox-sized piece of cheese and a small pot of yoghurt each day, you’ll easily hit your 700mg daily calcium target. 

Don’t want to eat dairy as part of your menopause diet? Load up on green leafy veg, dried fruit and fortified plant milks, all rich in the mineral, and speak to your doctor about whether you need calcium supplements. 

While calcium’s crucial, you also need vitamin D to absorb it properly. Summer sun is the best way to get this but take a supplement from October to March, as it’s important to keep levels steady - one study found seesawing between high and low levels at different times of the year could be as bad for your bones as lacking it all year round. 

You could also top up with vitamin D foods, such as eggs and oily fish – although they don’t contain enough to skip supplementation.  

Pack hormone-balancing foods into your menopause diet

Alison Cullen, nutritional practitioner and education manager at A Vogel, recommends including foods containing plant oestrogens – called phytoestrogens – which help balance falling oestrogen levels and may help ease some of your symptoms, such as hot flushes.

‘Isoflavones are a type of phytoestrogen found in soy foods,’ she says. Tuck into tofu - 100g gives you around 30mg of isoflavones, and it’s a versatile food that’s great stir-fried. 

You can also find phytoestrogens in beans, pulses and flax seeds, and it’s really worth making an effort to include these in your diet. You can add beans and pulses to stews, soups and curries, and add flax seeds to cereal, porridge or smoothies. 

Eat heart-healthy foods as part of your menopause diet

Before menopause, women’s heart risk is low because oestrogen helps prevent cholesterol sticking to artery walls and furring them up. But once you’ve lost the cardioprotective benefits of oestrogen, you’re more likely to have high cholesterol. Plus, with age, arteries stiffen and narrow. 

All these factors can raise your risk of having a heart attack or stroke after menopause, especially as you get older, so it’s really important to follow a heart-friendly diet. 

In general, a Mediterranean diet is best for overall health, including heart health – that means eating loads of fresh fruit and veg, olive oil, nuts, seeds and some oily fish, while avoiding meat, sugar and fried, processed foods.

Fibre’s also important for lowering cholesterol, pushing it out of the body before it can stick to artery walls. Fruit and vegetables are packed with it, so that’s another reason to eat plenty – check out our guide to easy ways to get your five-a-day. Plus it can help fill you up, meaning you’re less likely to reach for unhealthy junk food.